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Organization
LH SELF MEDICAL SERVICES PC
Active
Organization
LH SELF MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS H SELF MD (OWNER)
(702) 530-7769
Entity
Organization
Contact information
Practice address
1415 ROSS AVE, EL CENTRO, CA 92243
(702) 530-7769
Mailing address
315 S COAST HIGHWAY 101 # U14, ENCINITAS, CA 92024-3543
(702) 530-7769
(888) 858-1403
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7570
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019796
—
NV
Enumeration date
12/04/2006
Last updated
08/17/2019
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