Provider Demographics
NPI:1639540396
Name:MARK DAVID LEVINE MD NURSING SERVICES PC
Entity Type:Organization
Organization Name:MARK DAVID LEVINE MD NURSING SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-576-7898
Mailing Address - Street 1:3835 N FREEWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1928
Mailing Address - Country:US
Mailing Address - Phone:916-576-7898
Mailing Address - Fax:916-285-0338
Practice Address - Street 1:5776 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2832
Practice Address - Country:US
Practice Address - Phone:855-427-2778
Practice Address - Fax:916-285-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty