B. Douglas Lewis, M.D., a Professional Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

G48356 Issued in CA

Legal business name

B. DOUGLAS LEWIS, M.D., A PROFESSIONAL CORPORATION

Practice address

3351 El Camino Real Ste 205
Atherton, CA 94027-3864

Phone

(650) 364-3600

Fax

(650) 364-3609

NPI assigned

Oct 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Douglas Lewis, M.D.

Title

President

Phone

(650) 364-3600

Specialties & licenses 2

Addresses

Other names 1

• Peninsula Vascular Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1013168491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL STE 205",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "940273864",
            "telephone_number": "650-364-3600",
            "fax_number": "650-364-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL STE 205",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "940273864",
            "telephone_number": "650-364-3600",
            "fax_number": "650-364-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B. DOUGLAS LEWIS, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-364-3600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G48356",
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "G48356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Anderson, M.D.
• Virginia Marguerite Anderson, PH.D.
• Andrew B Newman M D Apc
• Atherton Plastic Surgery Center
• Katarina Rose Azzimonti, BS
• John Barman, MPT
• Jennifer Elizabeth Berry
• Bilgen Esen Boyacigiller, RDN
• Brian W. Fong, DMD, Inc.
• Michael Brugos, DDS

• Medical Specialty Clinic/Center in Atherton, CA
• Providers in Atherton, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.