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General NPI Number Information
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NPI Number | 1457543894
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Entity Type | Individual
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Provider Name | DR. MEARLE DAVID LEWIS
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Gender | Male
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 115 BARRINGTON WALK
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City | LOS ANGELES
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State | CA
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Zip | 90049-2931
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Country | US
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Telephone | 310-589-1600
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Fax | 310-589-1607
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Provider Business Mailing Address
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Address Line | PO BOX 6150
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City | MALIBU
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State | CA
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Zip | 90264
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Country | US
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Telephone | 310-589-1600
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Fax | 310-589-1607
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | C39057
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | C39057
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License Number State | CA
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