MEDICARE: DR. DOUGLAS ALAN LEWIS D.C.

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
1	111NR0400X	Rehabilitation Chiropractor	DC17739	CA

General Provider Information

NPI Number	:	1215064001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS ALAN LEWIS D.C.

Provider Business Mailing Address
First Line	:	1520 MERRITT ST
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95380-4249
Country	:	US
Telephone Number	:	209-634-5192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 N PALM ST
Second Line	:	STE. B
City	:	TURLOCK
State	:	CA
Zip	:	95380-3319
Country	:	US
Telephone Number	:	209-668-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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