MEDICARE: MANSOUR BENLEVY 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	207R00000X	Internal Medicine Physician	A44640	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669516159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANSOUR BENLEVY MD

Provider Business Mailing Address
First Line	:	1101 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1701
Country	:	US
Telephone Number	:	323-665-4230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1701
Country	:	US
Telephone Number	:	323-665-4230
Fax Number	:	323-665-8718

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	12/03/2013

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Directions to “ MANSOUR BENLEVY MD” Practice Location

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