Provider Demographics
NPI:1598780116
Name:LEWIN, HOWARD CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:CHARLES
Last Name:LEWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11835 W OLYMPIC BLVD STE 1150
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5078
Mailing Address - Country:US
Mailing Address - Phone:323-655-7610
Mailing Address - Fax:888-808-0270
Practice Address - Street 1:11835 W OLYMPIC BLVD STE 1150
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5078
Practice Address - Country:US
Practice Address - Phone:323-655-7610
Practice Address - Fax:888-808-0270
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79325207UN0901X
AZ32818207UN0901X
IL036-116193207UN0901X
MO2006007045207UN0901X
NMTM2006-0419207UN0901X
SD5856207UN0901X
TN40639207UN0901X
WAMD00046560207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G793250OtherMEDI-CAL PROVIDER #
CAW15815Medicare ID - Type Unspecified
G60139Medicare UPIN