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Individual

BRIAN JOEL LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
50 MATHER RD, SAN ANSELMO, CA 94960-1047
(415) 454-2676
Mailing address
50 MATHER RD, SAN ANSELMO, CA 94960-1047
(415) 454-2676

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G26437
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G264370
CA
Enumeration date
11/01/2006
Last updated
08/07/2007
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