Individual
DR. GENA LEE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5220 CLAREMONT AVE, OAKLAND, CA 94618-1033
(510) 428-3885
(510) 547-2702
Mailing address
5220 CLAREMONT AVE, OAKLAND, CA 94618-1033
(510) 428-3885
(510) 547-2702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A061397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
542125582
FEDERAL TAX ID NO.-OUTPAT
CA
01
—
680572143
FEDERAL TAX ID NO. INPATI
CA
05
—
GR0095800
—
CA
Enumeration date
07/11/2006
Last updated
07/18/2007
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