Active NPI
Chris E Lewis
- Physician Assistant
- Vista, CA
National Provider Identifier
1407883127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12999
- Practice address
- 910 Sycamore Ave
Suite 102
Vista, CA 92081-7832 - Phone
- (760) 598-1700
- Fax
- (760) 598-1196
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12999 | CA | Primary |
Addresses
Primary practice location
910 Sycamore Ave
Suite 102
Vista, CA 92081-7832
Mailing address
PO Box 232410
Suite 270
San Diego, CA 92193-2410
Phone (760) 598-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PA129990 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12999 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470009600000",
"number": "1407883127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"address_2": "SUITE 270",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410",
"telephone_number": "760-598-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 SYCAMORE AVE",
"address_2": "SUITE 102",
"city": "VISTA",
"state": "CA",
"postal_code": "920817832",
"telephone_number": "760-598-1700",
"fax_number": "760-598-1196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "CHRIS",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2016-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA12999",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0PA129990",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.