Provider Demographics
NPI:1497849608
Name:LEVY, JODY D (MD)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:D
Last Name:LEVY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9602
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:818-837-5559
Mailing Address - Fax:818-792-4793
Practice Address - Street 1:18133 VENTURA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2641
Practice Address - Country:US
Practice Address - Phone:818-466-7700
Practice Address - Fax:818-898-1808
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC41413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88245Medicare UPIN