Provider Demographics
NPI:1669414793
Name:LEVIN, EMIL (MD)
Entity type:Individual
Prefix:DR
First Name:EMIL
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8995 KEITH AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4919
Mailing Address - Country:US
Mailing Address - Phone:310-859-1924
Mailing Address - Fax:323-848-1884
Practice Address - Street 1:8264 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5915
Practice Address - Country:US
Practice Address - Phone:323-650-1789
Practice Address - Fax:323-848-1884
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA36761208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28174Medicare UPIN