MEDICARE: DANIEL LEVITAN MD INC

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	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1538150164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL LEVITAN MD INC

Provider Business Mailing Address
First Line	:	255 E ORANGE GROVE AVE
Second Line	:	STE D
City	:	BURBANK
State	:	CA
Zip	:	91502-1240
Country	:	US
Telephone Number	:	818-848-5595
Fax Number	:	818-848-5749

Provider Business Practice Location Address
First Line	:	255 E ORANGE GROVE AVE
Second Line	:	STE D
City	:	BURBANK
State	:	CA
Zip	:	91502-1240
Country	:	US
Telephone Number	:	818-848-5595
Fax Number	:	818-848-5749

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL LEVITAN
Credential	:	MD
Telephone Number	:	818-848-5595

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	08/22/2020

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