Organization Name: | MELVYN M. LEWIN, PHD PSYCHOLOGICAL CORP |
NPI Number: | 1528286077 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELVYN MATTHEW LEWIN (PRESIDENT) |
Mailing Address: | 716 Yarmouth Rd Suite D Palos Verdes Estates |
State: | CA US |
Postal Code: | 902742654 |
Phone Number: | 3103771198 |
Fax Number: | 3107919627 |
NPI Enumeration Date: | 04/22/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY5446 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |