Provider Demographics
NPI:1063503050
Name:LEWIN, SHERYL LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:LEWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23430 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4720
Mailing Address - Country:US
Mailing Address - Phone:310-828-1414
Mailing Address - Fax:310-347-4255
Practice Address - Street 1:23430 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4720
Practice Address - Country:US
Practice Address - Phone:310-828-1414
Practice Address - Fax:310-347-4255
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA722492086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A722490Medicaid
CAI12158Medicare UPIN
CAWA72249AMedicare ID - Type Unspecified