Provider Demographics
NPI:1467744409
Name:OFFICE OF ALAN LEVENTHAL P.C.
Entity Type:Organization
Organization Name:OFFICE OF ALAN LEVENTHAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-957-8942
Mailing Address - Street 1:5544 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90022-4104
Mailing Address - Country:US
Mailing Address - Phone:323-721-4488
Mailing Address - Fax:323-721-4788
Practice Address - Street 1:5544 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90022-4104
Practice Address - Country:US
Practice Address - Phone:323-721-4488
Practice Address - Fax:323-721-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL5153332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA6075OtherEYEMED