Provider Demographics
NPI:1003828153
Name:LEVINE, SEYMOUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NORTH ROBERTSON BLVD
Mailing Address - Street 2:#350
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-687-2855
Mailing Address - Fax:310-687-7433
Practice Address - Street 1:150 NORTH ROBERTSON BLVD
Practice Address - Street 2:#350
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-687-2855
Practice Address - Fax:310-687-7433
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34469207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C344690Medicaid
CAA87734Medicare UPIN