Healthcare Provider Details

I. General information

NPI: 1184249468
Provider Name (Legal Business Name): SOPHIA YENCHUAN KUO LEWIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE FL 2
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

PO BOX 60352
SAINT LOUIS MO
63160-0352
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2626
  • Fax:
Mailing address:
  • Phone: 314-362-5060
  • Fax: 314-362-6959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2022012575
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number2022012575
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2022012575
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA195468
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA195468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: