MEDICARE: DR. MYRA LEVINSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	A38605	CA
2	207VG0400X	Gynecology Physician	A38605	CA

General Provider Information

NPI Number	:	1083955959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRA LEVINSON MD

Provider Business Mailing Address
First Line	:	336 S CANON DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4516
Country	:	US
Telephone Number	:	310-780-2003
Fax Number	:	310-772-0940

Provider Business Practice Location Address
First Line	:	336 S CANON DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4516
Country	:	US
Telephone Number	:	310-780-2003
Fax Number	:	310-772-0940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2013
Last Update Date	:	03/02/2013

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