Individual
CLARISSA GRACE LEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11234 ANDERSON ST, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354-2804
(909) 558-8131
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A11066
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2008
Last updated
11/30/2021
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