Provider Demographics
NPI:1710183140
Name:DENNIS PATRICK LEWIS,MD,
Entity Type:Organization
Organization Name:DENNIS PATRICK LEWIS,MD,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-254-0026
Mailing Address - Street 1:23823 VALENCIA BLVD
Mailing Address - Street 2:SUITE #160
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-9512
Mailing Address - Country:US
Mailing Address - Phone:661-254-0026
Mailing Address - Fax:661-254-1773
Practice Address - Street 1:23823 VALENCIA BLVD
Practice Address - Street 2:SUITE #160
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9512
Practice Address - Country:US
Practice Address - Phone:661-254-0026
Practice Address - Fax:661-254-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF81932Medicare UPIN
CAW17015Medicare PIN
CA5450570001Medicare NSC