Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 24514 | CA |
Y | 103TC0700X | Clinical Psychologist | 24514 | CA |
NPI | 1003046970 |
---|---|
Provider Name | Dr. David Tim Lewis |
First Address | San Francisco, CA 94103-2122 |
Second Address | San Francisco, CA 94103-2122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2009 |
Last Update Date | 03/06/2013 |