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NPI Code Detail

MEDICARE: DENNIS J LYONS DPM

MEDICARE: DENNIS J LYONS DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristE2283CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15006060001OTHERCADME NORIDIAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154314011
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS J LYONS DPM
Provider Business Mailing Address
First Line : PO BOX 19183
Second Line :
City : OAKLAND
State : CA
Zip : 94619-0183
Country : US
Telephone Number : 510-530-0840
Fax Number : 510-530-0873
Provider Business Practice Location Address
First Line : 4247 MAC ARTHUR BLVD.
Second Line :
City : OAKLAND
State : CA
Zip : 94619-1907
Country : US
Telephone Number : 510-530-0840
Fax Number : 510-530-0873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 04/17/2008

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