Provider Demographics
NPI:1053640409
Name:LEVIN, PAUL JEREMY MAXWELL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JEREMY MAXWELL
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MAX
Other - Middle Name:
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1954 HILLHURST AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2722
Mailing Address - Country:US
Mailing Address - Phone:323-913-1930
Mailing Address - Fax:
Practice Address - Street 1:2016 HILLHURST AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2703
Practice Address - Country:US
Practice Address - Phone:323-913-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor