Healthcare Provider Details

I. General information

NPI: 1538197942
Provider Name (Legal Business Name): SAUL LEVINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 CHILDRENS WAY SUITE 111
SAN DIEGO CA
92123-4232
US

IV. Provider business mailing address

3030 CHILDRENS WAY SUITE 111
SAN DIEGO CA
92123-4232
US

V. Phone/Fax

Practice location:
  • Phone: 858-966-4936
  • Fax: 858-627-0710
Mailing address:
  • Phone: 858-966-4936
  • Fax: 858-627-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA21445
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA21445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: