| Organization Name: | DANA MARIE LEWIS, D.O., INC |
| NPI Number: | 1124124250 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANA MARIE LEWIS (BUSINESS OWNER) |
| Mailing Address: | 10052 Alta Sierra Dr Suite A Grass Valley |
| State: | CA US |
| Postal Code: | 959496886 |
| Phone Number: | 5304779100 |
| Fax Number: | 5304772033 |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A7088 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |