Provider Demographics
NPI:1104833375
Name:FOSTER, LIONEL S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:S
Last Name:FOSTER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:370 DEL NORTE STREET
Mailing Address - Street 2:#204
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-751-4792
Mailing Address - Fax:530-751-4793
Practice Address - Street 1:370 DEL NORTE STREET
Practice Address - Street 2:#204
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-751-4792
Practice Address - Fax:530-751-4793
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-11-20
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Provider Licenses
StateLicense IDTaxonomies
CAG60284208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF34539Medicare UPIN
CA00G602841Medicare ID - Type Unspecified