ETHAN LEW (NPI# 1871100404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871100404 |
| Entity Type | Individual |
| Full Name | ETHAN LEW |
| Credential | PA-C |
| Practice Address |
15589 Corte Enrico San Lorenzo CA 94580-1461 |
| Practice Telephone | 5102200868 |
| Mailing Telephone | 5102200868 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15589 CORTE ENRICO |
| City | SAN LORENZO |
| State | CA |
| Zip Code | 94580-1461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497226047 | Sunrise Care Home LLC | Clinic/Center | 1447 Via Lucas, San Lorenzo, CA 94580 | 2018-12-07 |
| 1700370459 | Andrea Gisela Sanchez - Altamirano | Behavioral Analyst | 16215 Via Arriba Apt 205, San Lorenzo, CA 94580 | 2018-06-17 |
| 1700326030 | Cozy Physical Therapy | Clinic/Center | 16012 Via Granada, San Lorenzo, CA 94580 | 2017-03-06 |
| 1912255605 | Brandi S Gates | Lactation Consultant, Non-RN | 1474 Via Coralla, San Lorenzo, CA 94580 | 2012-08-28 |
| 1255525572 | Charlex Corp Usa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 16829 Daryl Ave, San Lorenzo, CA 94580 | 2007-08-29 |
| 1194917187 | Charlex Corp Usa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 16837 Daryl Ave, San Lorenzo, CA 94580 | 2007-08-14 |
| 1629136080 | Winston F Yee | Dentist | 17760 Hesperian Blvd, San Lorenzo, CA 94580 | 2006-12-05 |
| 1871686568 | Linh P Nguyen | Chiropractor | 15817 Channel Street, San Lorenzo, CA 94580 | 2006-10-02 |
| 1821024902 | John Peter Derdivanis | Dentist | 15600 Washington Ave.ste.e, San Lorenzo, CA 94580 | 2006-06-23 |
| 1588104608 | Cozy Physical Therapy Professional Corporation | Clinic/Center | 16012 Via Granada, San Lorenzo, CA 94580 | 2017-03-08 |
| Find all providers in zip 94580 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
| City | SAN LORENZO |
| Zip Code | 94580 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.