Healthcare Provider Details

I. General information

NPI: 1477585156
Provider Name (Legal Business Name): MARGARET J LEWIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET J RANNARD

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 UNIVERSITY AVE
SAN DIEGO CA
92103-3312
US

IV. Provider business mailing address

FILE # 55745
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 619-291-0030
  • Fax: 619-291-0095
Mailing address:
  • Phone: 619-291-0030
  • Fax: 619-291-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: