# DANA MARIE LEWIS, D.O., INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124124250
- **Authorized official:** DANA MARIE LEWIS D.O. (BUSINESS OWNER)
- **Authorized official phone:** (530) 477-9100

## Contact information

- **Practice address:** 10052 ALTA SIERRA DR, SUITE A, GRASS VALLEY, CA 95949-6886
- **Practice address phone:** (530) 477-9100
- **Practice address fax:** (530) 477-2033
- **Mailing address:** 10052 ALTA SIERRA DR, SUITE A, GRASS VALLEY, CA 95949-6886
- **Mailing address phone:** (530) 477-9100
- **Mailing address fax:** (530) 477-2033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 20A7088 | CA | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00AX70880 | — | CA |