Provider Demographics
NPI:1932143872
Name:LEVY, HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6949 EL CAMINO REAL
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4140
Mailing Address - Country:US
Mailing Address - Phone:760-438-2020
Mailing Address - Fax:
Practice Address - Street 1:6949 EL CAMINO REAL
Practice Address - Street 2:SUITE 105
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4140
Practice Address - Country:US
Practice Address - Phone:760-438-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA6848152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP6848Medicare PIN