Healthcare Provider Details

I. General information

NPI: 1376645978
Provider Name (Legal Business Name): BERTHA MEI GEE-LEW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 6TH AVE SUITE 101
SAN DIEGO CA
92103-6308
US

IV. Provider business mailing address

2850 6TH AVE SUITE 101
SAN DIEGO CA
92103-6308
US

V. Phone/Fax

Practice location:
  • Phone: 619-295-3911
  • Fax: 619-295-4356
Mailing address:
  • Phone: 619-295-3911
  • Fax: 619-295-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG38238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: