Individual
LINDA K LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6920 CORTE LANGOSTA, CARLSBAD, CA 92009-6094
(216) 255-5700
(216) 255-5701
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122
(216) 255-5701
(216) 255-5701
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
G50433
CA
2085R0202X
Diagnostic Radiology Physician
G50433
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067496
—
MT
01
—
00G504330
BCBS
CA
05
—
00G504330
—
CA
05
—
1016646250001
—
PA
05
—
2309219
—
OH
01
—
300135801
RXR MEDICARE
CA
05
—
523625428
—
NE
05
—
73383302
—
AZ
05
—
7705910
—
SD
05
—
806430800
—
ID
Enumeration date
11/11/2005
Last updated
10/10/2011
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