Provider Demographics
NPI:1437174927
Name:MELTZ, LEWIS N (DC)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:N
Last Name:MELTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:LEWIS
Other - Middle Name:N
Other - Last Name:MELTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:981 GOVERNOR DR
Mailing Address - Street 2:STE. 102
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4292
Mailing Address - Country:US
Mailing Address - Phone:916-933-2707
Mailing Address - Fax:916-933-2708
Practice Address - Street 1:981 GOVERNOR DR
Practice Address - Street 2:STE. 102
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4292
Practice Address - Country:US
Practice Address - Phone:916-933-2707
Practice Address - Fax:916-933-2708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15313111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT05710Medicare UPIN