Provider Demographics
NPI:1942326376
Name:LEVENTAKIS, CATHY H (OD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:H
Last Name:LEVENTAKIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:H
Other - Last Name:MUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1150 KWIS AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-2112
Mailing Address - Country:US
Mailing Address - Phone:626-222-3711
Mailing Address - Fax:310-838-8031
Practice Address - Street 1:3831 HUGHES AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2751
Practice Address - Country:US
Practice Address - Phone:310-838-3834
Practice Address - Fax:310-838-3081
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT13049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist