Individual
KELLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
649 W MISSION AVE, ESCONDIDO, CA 92025-1610
(760) 740-3000
Mailing address
13970 MENNONITE PT, SAN DIEGO, CA 92129-3134
(858) 703-7263
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
95120156
CA
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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