Provider Demographics
NPI:1780608190
Name:LEWIS, DENNIS P (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23823 VALENCIA BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-9312
Mailing Address - Country:US
Mailing Address - Phone:661-254-0026
Mailing Address - Fax:661-254-1773
Practice Address - Street 1:23823 VALENCIA BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9312
Practice Address - Country:US
Practice Address - Phone:661-254-0026
Practice Address - Fax:661-254-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2015-08-07
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Provider Licenses
StateLicense IDTaxonomies
CAG78417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5450570001Medicare NSC
CAWG78417EMedicare PIN
CAF81932Medicare UPIN