Provider Demographics
NPI:1285665372
Name:LEWANDOWSKI, PETER PAUL (DC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:PAUL
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NEW MONTGOMERY ST
Mailing Address - Street 2:MEZZANINE LEVEL
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-3412
Mailing Address - Country:US
Mailing Address - Phone:415-896-2273
Mailing Address - Fax:415-896-2275
Practice Address - Street 1:55 NEW MONTGOMERY ST
Practice Address - Street 2:MEZZANINE LEVEL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3412
Practice Address - Country:US
Practice Address - Phone:415-896-2273
Practice Address - Fax:415-896-2275
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0198960OtherBLUE SHIELD PROVIDER ID