Provider Demographics
NPI:1609816537
Name:LEWIS, STERLING F (DO)
Entity Type:Individual
Prefix:
First Name:STERLING
Middle Name:F
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23435 E CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-5541
Mailing Address - Country:US
Mailing Address - Phone:831-475-3127
Mailing Address - Fax:831-464-1723
Practice Address - Street 1:75 NIELSON ST
Practice Address - Street 2:EM DEPT
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2468
Practice Address - Country:US
Practice Address - Phone:831-761-5613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4732207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609816537Medicaid
CA20A4732OtherANTHEM BLUE CROSS
CA1609816537Medicaid
CAAY884ZMedicare PIN