Provider Demographics
NPI:1326355660
Name:LEMUS, MICHAEL H (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:LEMUS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28949
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8949
Mailing Address - Country:US
Mailing Address - Phone:559-228-5400
Mailing Address - Fax:559-224-3920
Practice Address - Street 1:560 E HERNDON AVE
Practice Address - Street 2:STE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2907
Practice Address - Country:US
Practice Address - Phone:559-437-7380
Practice Address - Fax:559-437-7162
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20202363AM0700X, 363A00000X
CA20202363AS0400X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical