# LEWIS WYATT JR. M.D. INC.

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

## Provider details

- **NPI number:** 1174039333
- **Authorized official:** DR. LEWIS WYATT JR. MD (PRESIDENT)
- **Authorized official phone:** (310) 360-7430

## Contact information

- **Practice address:** 99 N LA CIENEGA BLVD, BEVERLY HILLS, CA 90211-2222
- **Practice address phone:** (310) 360-7430
- **Practice address fax:** (310) 360-7430
- **Mailing address:** 2061 WESTRIDGE RD, LOS ANGELES, CA 90049-1805
- **Mailing address phone:** (310) 360-7430
- **Mailing address fax:** (310) 360-7435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 00C320300 | CA | Yes |

## Other

- **Enumeration date:** 12/22/2017
- **Last updated:** 06/16/2018