Provider Demographics
NPI:1740290485
Name:LEVIN, JEFFREY RUBIN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:RUBIN
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 STANDIFORD AVE
Mailing Address - Street 2:STE F
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1159
Mailing Address - Country:US
Mailing Address - Phone:209-579-5628
Mailing Address - Fax:209-579-5637
Practice Address - Street 1:1541 FLORIDA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4429
Practice Address - Country:US
Practice Address - Phone:209-521-0767
Practice Address - Fax:209-521-5204
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJL0531562084N0400X
CAA463042084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1307311791OtherBLUE CROSS
MI307646010Medicaid
CAA46304OtherMEDICAL LICENSE
MI1300926612OtherHEALTHPLUS
MI130014307OtherPALMETTO
MI1300926612OtherHEALTHPLUS
MIE47845Medicare UPIN