Provider Demographics
NPI:1710100987
Name:STEVEN E. LEVINE, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STEVEN E. LEVINE, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ELIOT
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-702-9211
Mailing Address - Street 1:PO BOX 802768
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-2768
Mailing Address - Country:US
Mailing Address - Phone:661-702-9211
Mailing Address - Fax:661-702-9255
Practice Address - Street 1:28001 SMYTH DR
Practice Address - Street 2:SUITE 108
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4024
Practice Address - Country:US
Practice Address - Phone:661-702-9211
Practice Address - Fax:661-702-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG402992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB56744Medicare UPIN