Organization
DR SHANNA R NEWBOLD M D INC
Active
Other names
SAN GORGONIO WOUND CARE
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA NEWBOLD MD (OWNER)
(951) 381-2122
Entity
Organization
Contact information
Practice address
264 N HIGHLAND SPRINGS AVE STE A, BANNING, CA 92220-3082
(951) 381-2122
(951) 561-7155
Mailing address
264 N HIGHLAND SPRINGS AVE STE A, BANNING, CA 92220-3082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
03/10/2026
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