Doctor Name: | BEVERLY LEWIS |
NPI Number: | 1760456529 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | G42697 |
Business Practice Address: | 2675 E Slauson Ave All Care Medical Group Inc Huntington Park, CA - 90255 |
Business Phone Number: | 3235896681 |
Business Fax Number: | 3235842505 |
Mailing Address: | 2675 E Slauson Ave, All Care Medical Group Inc HUNTINGTON PARK |
State: | CA |
Postal Code: | 90255 |
Phone Number: | 3235896681 |
Fax Number: | 3235842505 |
NPI Enumeration Date: | 02/16/2006 |
NPI Last Update Date: | 02/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G42697 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |