Provider Demographics
NPI:1497349500
Name:LEVINE, ERROL GELLERMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERROL
Middle Name:GELLERMAN
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DAKOTA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-6626
Mailing Address - Country:US
Mailing Address - Phone:831-420-7801
Mailing Address - Fax:831-429-1396
Practice Address - Street 1:111 DAKOTA AVE STE 2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-6626
Practice Address - Country:US
Practice Address - Phone:831-429-1188
Practice Address - Fax:831-429-1396
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor