Healthcare Provider Details

I. General information

NPI: 1003136318
Provider Name (Legal Business Name): DENNIS L. LEVIN, M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 PROFESSIONAL DR SUITE A
AUBURN CA
95602-2473
US

IV. Provider business mailing address

3227 PROFESSIONAL DR SUITE A
AUBURN CA
95602-2473
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-6300
  • Fax: 530-889-6303
Mailing address:
  • Phone: 530-889-6300
  • Fax: 530-889-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberG36601
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberG36601
License Number StateCA

VIII. Authorized Official

Name: DR. DENNIS LAWRENCE LEVIN
Title or Position: OWNER
Credential: MD
Phone: 530-889-6300