Healthcare Provider Details

I. General information

NPI: 1386943736
Provider Name (Legal Business Name): KAREN LEVINE CERTIFIED REGISTERED NURSING ANESTHETIST, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8555 FLORENCE AVE
DOWNEY CA
90240-4014
US

IV. Provider business mailing address

PO BOX 7793
SAN FRANCISCO CA
94120-7793
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-9351
  • Fax: 503-372-2755
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1949
License Number StateCA

VIII. Authorized Official

Name: KAREN L. LEVINE
Title or Position: SOLE PROPRIETOR
Credential: CRNA
Phone: 503-372-2740