Provider Demographics
NPI:1104160415
Name:LEAVITT, DANIEL FERRIN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FERRIN
Last Name:LEAVITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2450 SISTER MARY COLUMBA DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4356
Mailing Address - Country:US
Mailing Address - Phone:530-527-0414
Mailing Address - Fax:530-528-7923
Practice Address - Street 1:2450 SISTER MARY COLUMBA DR
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4356
Practice Address - Country:US
Practice Address - Phone:530-527-0414
Practice Address - Fax:530-528-9329
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2021-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC172218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine