Provider Demographics
NPI:1376645978
Name:GEE-LEW, BERTHA MEI (MD)
Entity Type:Individual
Prefix:
First Name:BERTHA
Middle Name:MEI
Last Name:GEE-LEW
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 1:2850 6TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6308
Mailing Address - Country:US
Mailing Address - Phone:619-295-3911
Mailing Address - Fax:619-295-4356
Practice Address - Street 1:2850 6TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6308
Practice Address - Country:US
Practice Address - Phone:619-295-3911
Practice Address - Fax:619-295-4356
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38238208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G382380Medicaid