Individual provider Active NPI

Mitchell W Lew, MD

  • Obstetrics & Gynecology Physician
  • Tustin, CA
National Provider Identifier
1427442672
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G64179 Issued in CA
Practice address
14642 Newport Ave Ste 101
Tustin, CA 92780-6058
Phone
(714) 581-6470
Fax
(714) 581-6492
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G64179 CA Primary

Addresses

Primary practice location

14642 Newport Ave Ste 101
Tustin, CA 92780-6058

Mailing address

PO Box 11466
Santa Ana, CA 92711-1466
Phone (714) 581-6470

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G64179CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Ipa Current Accepting new patients
Care@Home Solutions Ca Inc Current Accepting new patients
Prospect Foothill Urgent Care Current Accepting new patients

Locations

14642 Newport Ave
Ste 101
Tustin, CA 92780
Phone (714) 352-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1427442672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11466",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927111466",
            "telephone_number": "714-581-6470",
            "fax_number": "714-581-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806058",
            "telephone_number": "714-581-6470",
            "fax_number": "714-581-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEW",
        "first_name": "MITCHELL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G64179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.