NPIMap

Organization Active NPI

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

Doing business as Peninsula Vascular Center

  • Medical Specialty Clinic/Center
  • Atherton, CA
National Provider Identifier
1013168491
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G48356 Issued in CA
Legal business name
B. DOUGLAS LEWIS, M.D., A PROFESSIONAL CORPORATION
Doing business as
Peninsula Vascular Center
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
Last updated
Oct 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Brian Douglas Lewis, M.D.NPI 1770657090
Title
President
Phone
(650) 364-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G48356 CA Primary
Radiology Clinic/Center 261QR0200X G48356 CA

Addresses

Primary practice location

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

Mailing address

3351 El Camino Real Ste 205
Atherton, CA 94027-3864
Phone (650) 364-3600

Other names 1

  • Peninsula Vascular Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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"
        }
    ]
}

Other providers in Atherton, CA

Sources for this page

  • 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.