Organization
B. DOUGLAS LEWIS, M.D., A PROFESSIONAL CORPORATION
Active
Other names
Peninsula Vascular Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN DOUGLAS LEWIS M.D. (PRESIDENT)
(650) 364-3600
Entity
Organization
Contact information
Practice address
3351 EL CAMINO REAL STE 205, ATHERTON, CA 94027-3864
(650) 364-3600
(650) 364-3609
Mailing address
3351 EL CAMINO REAL STE 205, ATHERTON, CA 94027-3864
(650) 364-3600
(650) 364-3609
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G48356
CA
261QR0200X
Radiology Clinic/Center
G48356
CA
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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