Provider Demographics
NPI:1790014330
Name:SEYMOUR LEVINE MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SEYMOUR LEVINE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEYMOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-657-2855
Mailing Address - Street 1:150 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2127
Mailing Address - Country:US
Mailing Address - Phone:310-657-2855
Mailing Address - Fax:310-657-7433
Practice Address - Street 1:150 N ROBERTSON BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2127
Practice Address - Country:US
Practice Address - Phone:310-657-2855
Practice Address - Fax:310-657-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34469207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty