Provider Demographics
NPI:1215064001
Name:LEWIS, DOUGLAS ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALAN
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 MERRITT ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4249
Mailing Address - Country:US
Mailing Address - Phone:209-634-5192
Mailing Address - Fax:
Practice Address - Street 1:1001 N PALM ST
Practice Address - Street 2:STE. B
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3319
Practice Address - Country:US
Practice Address - Phone:209-668-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17739111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0177390Medicare ID - Type Unspecified