Provider Demographics
NPI:1922168004
Name:LEHMAN, DWAYNE ALLEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DWAYNE
Middle Name:ALLEN
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1516
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-1516
Mailing Address - Country:US
Mailing Address - Phone:909-337-7771
Mailing Address - Fax:909-337-5353
Practice Address - Street 1:29099 HOSPITAL ROAD STE 204B
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352-9235
Practice Address - Country:US
Practice Address - Phone:909-337-7771
Practice Address - Fax:909-337-5353
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13821363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical