Provider Demographics
NPI:1972642817
Name:LEW, LESTER K (OD)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:K
Last Name:LEW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3517
Mailing Address - Country:US
Mailing Address - Phone:626-282-4851
Mailing Address - Fax:626-576-4119
Practice Address - Street 1:230 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3517
Practice Address - Country:US
Practice Address - Phone:626-282-4851
Practice Address - Fax:626-576-4119
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8270T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0082700Medicaid
U61002Medicare UPIN
CAW0P8270AMedicare ID - Type Unspecified