Individual
JERRY LANE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9235 E BROADWAY ST, PLANADA, CA 95365-8088
(209) 382-0253
(209) 382-2110
Mailing address
737 W CHILDS AVE, MERCED, CA 95340-6805
(209) 383-1848
(209) 383-1296
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11479
CA
Other
Enumeration date
11/29/2005
Last updated
03/07/2023
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