Active NPI
Edmund W Lewis
- Substance Abuse Rehabilitation Facility
- Victorville, CA
National Provider Identifier
1225357791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- RW2973
- Practice address
- 13333 Palmdale Rd
Victorville, CA 92392-9364 - Phone
- (760) 241-4917
- Fax
- (760) 241-8911
- NPI assigned
- May 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | RW2973 | CA | Primary |
Addresses
Primary practice location
13333 Palmdale Rd
Victorville, CA 92392-9364
Mailing address
13333 Palmdale Rd
Victorville, CA 92392-9364
Phone (760) 241-4917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RW2973 | CA | MD | Substance Abuse Rehabilitation Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1225357791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13333 PALMDALE RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923929364",
"telephone_number": "760-241-4917",
"fax_number": "760-241-8911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13333 PALMDALE RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923929364",
"telephone_number": "760-241-4917",
"fax_number": "760-241-8911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "EDMUND",
"middle_name": "W",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-24",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "CA",
"license": "RW2973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.