Individual
JENNIFER LEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095
(310) 319-1234
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA18196
CA
363AS0400X
Surgical Physician Assistant
Primary
PA18196
CA
Other
Enumeration date
10/19/2006
Last updated
12/07/2018
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