MEDICARE: MRS. CHRISTINA MARIE LEWIS NP

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	363LP2300X	Primary Care Nurse Practitioner	RN380579	CA

General Provider Information

NPI Number	:	1699899641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA MARIE LEWIS NP

Provider Business Mailing Address
First Line	:	221 WESTWOOD PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1703
Country	:	US
Telephone Number	:	310-794-7283
Fax Number	:	310-267-1996

Provider Business Practice Location Address
First Line	:	221 WESTWOOD PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1703
Country	:	US
Telephone Number	:	310-794-7283
Fax Number	:	310-267-1996

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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