Provider Demographics
NPI:1699335521
Name:LOTUS HEALTH, LLC
Entity type:Organization
Organization Name:LOTUS HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-872-8846
Mailing Address - Street 1:1776 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1951
Mailing Address - Country:US
Mailing Address - Phone:801-872-8846
Mailing Address - Fax:801-449-0982
Practice Address - Street 1:2605 E 3300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-2728
Practice Address - Country:US
Practice Address - Phone:801-872-8846
Practice Address - Fax:801-449-0982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty