Provider Demographics
NPI:1528231768
Name:PREWITT, LAUREN ANNETTE (DO)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANNETTE
Last Name:PREWITT
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50706
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93150-0706
Mailing Address - Country:US
Mailing Address - Phone:805-963-3757
Mailing Address - Fax:805-564-3332
Practice Address - Street 1:1223 HIGUERA ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3145
Practice Address - Country:US
Practice Address - Phone:805-776-3002
Practice Address - Fax:805-693-4282
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2018-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A 9370207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB235827Medicare PIN
CAW15907Medicare PIN