Healthcare Provider Details

I. General information

NPI: 1477596815
Provider Name (Legal Business Name): JEFFREY LEVY MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date: 06/22/2006
Reactivation Date: 10/19/2007

III. Provider practice location address

2070 CLINTON AVE
ALAMEDA CA
94501
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 510-522-3700
  • Fax:
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY LEVY
Title or Position: PRESIDENT
Credential: MD
Phone: 510-522-3700