Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | G31323 | CA |
NPI | 1306917166 |
---|---|
Provider Name | William James Lewis |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92123-2778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 19/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G313230 | (05) | CA |