MEDICARE: DR. MICHAEL S LEWIS M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	237025	NY
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A102134	CA

General Provider Information

NPI Number	:	1306047139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S LEWIS M.D.

Provider Business Mailing Address
First Line	:	11301 WILSHIRE BLVD RM 1256
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD RM 1256
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	06/22/2024

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Directions to “ DR. MICHAEL S LEWIS M.D.” Practice Location

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