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General NPI Number Information
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NPI Number | 1649121054
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Entity Type | Individual
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Provider Name | BROOKE LEWIS
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Gender | Female
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1201 W LA VETA AVE
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City | ORANGE
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State | CA
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Zip | 92868-4203
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Country | US
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Telephone | 714-509-9063
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Fax |
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Provider Business Mailing Address
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Address Line | 6061 HAZELBROOK AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-1160
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Country | US
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Telephone |
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 703274
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License Number State | CA
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