Provider Demographics
NPI:1629032891
Name:LEVINE, BRIAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 25033
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92799-5033
Mailing Address - Country:US
Mailing Address - Phone:714-347-1000
Mailing Address - Fax:714-347-1082
Practice Address - Street 1:681 S PARKER ST STE 150
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4761
Practice Address - Country:US
Practice Address - Phone:714-744-0900
Practice Address - Fax:714-744-9232
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG31809207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91369Medicare UPIN