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David Bram Lewis

Pediatrics

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as DAVID LEWIS.

Based on the most recent information from CMS, provider David Bram Lewis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1255466983
Provider Type
Individual
Full Name
Lewis, David Bram
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
2/22/2007
Last Updated
4/26/2024

Contact Information

Practice Location

725 Welch Rd, Palo Alto, CA 94304-1601

(650) 723-0290

Unlisted Fax

Mailing Location

725 Welch Rd, Palo Alto, CA 94304-1601

(650) 723-0290

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License G48589 California
Code 2080P0208X	Description Pediatrics Allopathic & Osteopathic Physicians	License G48589 California

Provider Identifiers

ID	Description	Issuer
ID 00G485890	Description Medicaid	Issuer Unlisted California

David Bram Lewis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Critchlow, Alaina Anne