Provider Demographics
NPI:1477154730
Name:LEMAY, DREW MATTHEW (PT)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:MATTHEW
Last Name:LEMAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S EL CAMINO REAL
Mailing Address - Street 2:APARTMENT 205
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672
Mailing Address - Country:US
Mailing Address - Phone:219-229-9379
Mailing Address - Fax:
Practice Address - Street 1:2501 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3350
Practice Address - Country:US
Practice Address - Phone:219-229-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296357208100000X
COPTL16026208100000X
HIPT-4913208100000X
TX1308216208100000X
WAPT.PT.61049572208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation