Provider Demographics
NPI:1477585156
Name:LEWIS, MARGARET J (MS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:J
Other - Last Name:RANNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:FILE # 55745
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0001
Mailing Address - Country:US
Mailing Address - Phone:619-291-0030
Mailing Address - Fax:619-291-0095
Practice Address - Street 1:1244 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3312
Practice Address - Country:US
Practice Address - Phone:619-291-0030
Practice Address - Fax:619-291-0095
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1766231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU1766CMedicare PIN
CAWAU1766AMedicare PIN
CAWAU1766BMedicare PIN