Organization
DAVID H LYON A PROFESSIONAL CORPORATION
Active
Other names
David H Lyon MD
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE SMITH (SUPERVISOR)
(209) 552-7551
Entity
Organization
Contact information
Practice address
4701 SISK RD, SUITE 103, MODESTO, CA 95356-9320
(888) 582-0814
(209) 526-6841
Mailing address
PO BOX 579120, MODESTO, CA 95357-9120
(888) 582-0814
(209) 526-6841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00A431800
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A431800
STATE LICENSE NUMBER
CA
Enumeration date
10/31/2014
Last updated
12/23/2014
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