Healthcare Provider Details

I. General information

NPI: 1992099154
Provider Name (Legal Business Name): STEPHEN B. LEWIS, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 EAST ST SUITE 15
CONCORD CA
94520-1928
US

IV. Provider business mailing address

2425 EAST ST SUITE 15
CONCORD CA
94520-1928
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-9232
  • Fax: 925-672-2198
Mailing address:
  • Phone: 925-682-9232
  • Fax: 925-672-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG20175
License Number StateCA

VIII. Authorized Official

Name: DR. STEPHEN B. LEWIS
Title or Position: MD
Credential:
Phone: 925-682-9232