Healthcare Provider Details

I. General information

NPI: 1356543128
Provider Name (Legal Business Name): MICHAEL LEVIN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 UNIVERSITY AVE STE 140
SACRAMENTO CA
95825-6535
US

IV. Provider business mailing address

333 UNIVERSITY AVE STE 140
SACRAMENTO CA
95825-6535
US

V. Phone/Fax

Practice location:
  • Phone: 916-333-5800
  • Fax: 916-333-5937
Mailing address:
  • Phone: 916-333-5800
  • Fax: 916-333-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: IRENE BOBERICK
Title or Position: MEDICAL BILLING SPECIALIST
Credential:
Phone: 916-549-3946