Provider Demographics
NPI:1083955959
Name:LEVINSON, MYRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRA
Middle Name:
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 S CANON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4516
Mailing Address - Country:US
Mailing Address - Phone:310-780-2003
Mailing Address - Fax:310-772-0940
Practice Address - Street 1:336 S CANON DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4516
Practice Address - Country:US
Practice Address - Phone:310-780-2003
Practice Address - Fax:310-772-0940
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38605207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology