Provider Demographics
NPI:1447472162
Name:LEWIS, RONALD FRANCIS (RDO)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:FRANCIS
Last Name:LEWIS
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2301 W ALPINE AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-2701
Mailing Address - Country:US
Mailing Address - Phone:209-464-0669
Mailing Address - Fax:209-460-1878
Practice Address - Street 1:2301 W ALPINE AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-2701
Practice Address - Country:US
Practice Address - Phone:209-464-0669
Practice Address - Fax:209-460-1878
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL1731156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician