Provider Demographics
NPI:1316028038
Name:RONALD D LEVIN MD INC
Entity Type:Organization
Organization Name:RONALD D LEVIN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-640-6610
Mailing Address - Street 1:2 BARISTO
Mailing Address - Street 2:NA
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:NA
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
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?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty