Provider Demographics
NPI:1063469542
Name:LEMUS, JULIO FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:FERNANDO
Last Name:LEMUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2385 ROSCOMARE RD
Mailing Address - Street 2:SUITE D4
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1838
Mailing Address - Country:US
Mailing Address - Phone:310-991-7718
Mailing Address - Fax:310-476-4111
Practice Address - Street 1:120 S MONTEBELLO BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4730
Practice Address - Country:US
Practice Address - Phone:323-726-0533
Practice Address - Fax:310-476-4111
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA44494207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF11662Medicare UPIN