Provider Demographics
NPI:1598051013
Name:LEVINE, ADAM SETH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SETH
Last Name:LEVINE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19105 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1428
Mailing Address - Country:US
Mailing Address - Phone:813-382-6022
Mailing Address - Fax:
Practice Address - Street 1:19105 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-1428
Practice Address - Country:US
Practice Address - Phone:813-382-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist