Provider Demographics
NPI:1417102518
Name:STEPHEN B. LEWIS M.D. ENDOCRINOLOGY PRACTICE INC.
Entity Type:Organization
Organization Name:STEPHEN B. LEWIS M.D. ENDOCRINOLOGY PRACTICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:BARNETT
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-682-9232
Mailing Address - Street 1:2425 EAST ST
Mailing Address - Street 2:#15
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-682-9232
Mailing Address - Fax:925-682-1120
Practice Address - Street 1:2425 EAST ST
Practice Address - Street 2:#15
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1928
Practice Address - Country:US
Practice Address - Phone:925-682-9232
Practice Address - Fax:925-682-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20175174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty