Healthcare Provider Details

I. General information

NPI: 1245358993
Provider Name (Legal Business Name): STEPHEN M LEWINSON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 WILSHIRE BLVD SUITE # 308
BEVERLY HILLS CA
90211-1838
US

IV. Provider business mailing address

PO BOX 5322
PLAYA DEL REY CA
90296-5322
US

V. Phone/Fax

Practice location:
  • Phone: 310-313-5027
  • Fax: 815-346-5796
Mailing address:
  • Phone: 310-313-5027
  • Fax: 815-346-5796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: