Healthcare Provider Details

I. General information

NPI: 1750623690
Provider Name (Legal Business Name): MARCUS RAYMOND LEWIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

IV. Provider business mailing address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC205410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: