Provider Demographics
NPI:1245358993
Name:LEWINSON, STEPHEN M (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:LEWINSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5322
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90296-5322
Mailing Address - Country:US
Mailing Address - Phone:310-313-5027
Mailing Address - Fax:815-346-5796
Practice Address - Street 1:9001 WILSHIRE BLVD
Practice Address - Street 2:SUITE # 308
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1838
Practice Address - Country:US
Practice Address - Phone:310-313-5027
Practice Address - Fax:815-346-5796
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE3757213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3757BMedicare PIN