Provider Demographics
NPI:1184629859
Name:LEVY, BARBARA SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUSAN
Last Name:LEVY
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 1:1485 DEER HILL CT
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7429
Mailing Address - Country:US
Mailing Address - Phone:253-740-7350
Mailing Address - Fax:
Practice Address - Street 1:1485 DEER HILL CT
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7429
Practice Address - Country:US
Practice Address - Phone:253-740-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019274174400000X
CAG43461207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist