Provider Demographics
NPI:1356543128
Name:MICHAEL LEVIN, M.D., INC.
Entity type:Organization
Organization Name:MICHAEL LEVIN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-549-3946
Mailing Address - Street 1:333 UNIVERSITY AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6535
Mailing Address - Country:US
Mailing Address - Phone:916-333-5800
Mailing Address - Fax:916-333-5937
Practice Address - Street 1:333 UNIVERSITY AVE STE 140
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6535
Practice Address - Country:US
Practice Address - Phone:916-333-5800
Practice Address - Fax:916-333-5937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP3300X
CA207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26155ZMedicare ID - Type UnspecifiedMEDICARE GROUP #