Provider Demographics
NPI:1275833501
Name:LEVINE, CARY L (RPH)
Entity Type:Individual
Prefix:MR
First Name:CARY
Middle Name:L
Last Name:LEVINE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2706
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-5706
Mailing Address - Country:US
Mailing Address - Phone:718-755-8960
Mailing Address - Fax:877-445-1050
Practice Address - Street 1:4627 CARMEL MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6613
Practice Address - Country:US
Practice Address - Phone:858-523-1847
Practice Address - Fax:858-523-1851
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist