Doctor Name: | MARTIN D. LEVINE |
NPI Number: | 1669470860 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G021066 |
Business Practice Address: | 16311 Ventura Blvd Suite 680 Encino, CA - 914362124 |
Business Phone Number: | 8189908561 |
Business Fax Number: | 8189904432 |
Mailing Address: | 16311 Ventura Blvd, Suite 680 ENCINO |
State: | CA |
Postal Code: | 914362124 |
Phone Number: | 8189908561 |
Fax Number: | 8189904432 |
NPI Enumeration Date: | 07/12/2005 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G021066 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |