Individual
TINA EILEEN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMSC , PA-C
Contact information
Practice address
9663 SANTA MONICA BLVD STE 769, BEVERLY HILLS, CA 90210-4303
(310) 596-0038
Mailing address
9663 SANTA MONICA BLVD STE 769, BEVERLY HILLS, CA 90210-4303
(310) 596-0038
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19614
CA
Other
Enumeration date
06/16/2006
Last updated
02/02/2022
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