Provider Demographics
NPI:1881655769
Name:LEVINE, JOEL B (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:B
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8515 FLORENCE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4043
Mailing Address - Country:US
Mailing Address - Phone:562-904-1340
Mailing Address - Fax:562-869-8606
Practice Address - Street 1:8515 FLORENCE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4043
Practice Address - Country:US
Practice Address - Phone:562-904-1340
Practice Address - Fax:562-869-8606
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG380022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG38002EMedicare PIN
CAA47318Medicare UPIN
CAWG38002DMedicare PIN
CAWG38002GMedicare PIN
CAWG38002FMedicare PIN