Provider Demographics
NPI:1285868208
Name:LEVINE, MONICA DANDAPANI (MS,MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DANDAPANI
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3509
Mailing Address - Country:US
Mailing Address - Phone:949-642-1361
Mailing Address - Fax:949-642-1394
Practice Address - Street 1:351 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3509
Practice Address - Country:US
Practice Address - Phone:949-642-1361
Practice Address - Fax:949-642-1394
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPGC019170300000X
CAA191061207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No170300000XOther Service ProvidersGenetic Counselor, MS