Provider Demographics
NPI:1851356018
Name:GELMAN, LEV (MD)
Entity Type:Individual
Prefix:DR
First Name:LEV
Middle Name:
Last Name:GELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 BALBOA BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3583
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-242-8761
Practice Address - Street 1:8510 BALBOA BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3583
Practice Address - Country:US
Practice Address - Phone:818-637-2000
Practice Address - Fax:818-242-8761
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0219767Medicaid
OH110228540Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OH0807968Medicare PIN
OH0219767Medicaid
CAEQ430ZMedicare PIN
OHG34808Medicare UPIN
OHSP02781Medicare PIN