Healthcare Provider Details

I. General information

NPI: 1558318881
Provider Name (Legal Business Name): HARVEY DAVID LYONS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 SAVIERS RD
OXNARD CA
93033-5314
US

IV. Provider business mailing address

5855 OLIVAS PARK DR
VENTURA CA
93003-7672
US

V. Phone/Fax

Practice location:
  • Phone: 805-487-5588
  • Fax: 805-587-5589
Mailing address:
  • Phone: 805-667-2801
  • Fax: 805-667-2865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC38214
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC38214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: