Healthcare Provider Details

I. General information

NPI: 1457832081
Provider Name (Legal Business Name): AVI LEVITT NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 W MISSION RD
ALHAMBRA CA
91803-1310
US

IV. Provider business mailing address

2215 W MISSION RD
ALHAMBRA CA
91803-1310
US

V. Phone/Fax

Practice location:
  • Phone: 866-742-1130
  • Fax: 626-283-5787
Mailing address:
  • Phone: 866-742-1130
  • Fax: 626-283-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: