MEDICARE: STEPHEN B. LEWIS M.D. ENDOCRINOLOGY PRACTICE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G20175	CA

General Provider Information

NPI Number	:	1417102518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN B. LEWIS M.D. ENDOCRINOLOGY PRACTICE INC.

Provider Business Mailing Address
First Line	:	2425 EAST ST
Second Line	:	#15
City	:	CONCORD
State	:	CA
Zip	:	94520
Country	:	US
Telephone Number	:	925-682-9232
Fax Number	:	925-682-1120

Provider Business Practice Location Address
First Line	:	2425 EAST ST
Second Line	:	#15
City	:	CONCORD
State	:	CA
Zip	:	94520-1928
Country	:	US
Telephone Number	:	925-682-9232
Fax Number	:	925-682-1120

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN BARNETT LEWIS
Credential	:	MD
Telephone Number	:	925-682-9232

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

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