Provider Demographics
NPI:1295816999
Name:LEVIN, RONALD DAVID (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DAVID
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BARISTO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2984
Mailing Address - Country:US
Mailing Address - Phone:949-640-6610
Mailing Address - Fax:949-725-6473
Practice Address - Street 1:2 BARISTO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2984
Practice Address - Country:US
Practice Address - Phone:949-640-6610
Practice Address - Fax:949-725-6473
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG13590208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation