Provider Demographics
NPI:1578844924
Name:RICHARD LEVY, M.D. A PROFESS CORP
Entity Type:Organization
Organization Name:RICHARD LEVY, M.D. A PROFESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-929-9405
Mailing Address - Street 1:3580 CALIFORNIA ST.
Mailing Address - Street 2:#302
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1715
Mailing Address - Country:US
Mailing Address - Phone:415-929-9405
Mailing Address - Fax:415-929-1307
Practice Address - Street 1:3580 CALIFORNIA ST.
Practice Address - Street 2:#302
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1715
Practice Address - Country:US
Practice Address - Phone:415-929-9405
Practice Address - Fax:415-929-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27656207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A43438Medicare UPIN