MEDICARE: DR. GRACIA CONTAOI 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	208000000X	Pediatrics Physician	A38978	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386652600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRACIA CONTAOI LEWIS M.D

Provider Business Mailing Address
First Line	:	1930 WILSHIRE BLVD
Second Line	:	SUITE 1100
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3605
Country	:	US
Telephone Number	:	213-483-2620
Fax Number	:	213-483-7918

Provider Business Practice Location Address
First Line	:	2010 WILSHIRE BLVD
Second Line	:	2ND FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3507
Country	:	US
Telephone Number	:	213-483-9209
Fax Number	:	213-483-0250

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/08/2007

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