Provider Demographics
NPI:1184631541
Name:LEW, HENRY L (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:L
Last Name:LEW
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 1:1210 E ARQUES AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-5422
Mailing Address - Country:US
Mailing Address - Phone:808-517-7018
Mailing Address - Fax:
Practice Address - Street 1:1210 E ARQUES AVE STE 206
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5422
Practice Address - Country:US
Practice Address - Phone:408-431-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69723208100000X, 225400000X
HI130231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist