Provider Demographics
NPI:1467512509
Name:LEVENTHAL, BENNETT L (MD)
Entity Type:Individual
Prefix:
First Name:BENNETT
Middle Name:L
Last Name:LEVENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 PARNASSUS AVE
Mailing Address - Street 2:LPPI 152
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-1924
Mailing Address - Country:US
Mailing Address - Phone:415-502-1924
Mailing Address - Fax:415-476-7712
Practice Address - Street 1:401 PARNASSUS AVE
Practice Address - Street 2:LPPI 152
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-1924
Practice Address - Country:US
Practice Address - Phone:415-502-1924
Practice Address - Fax:415-476-7712
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-0572462084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry