Healthcare Provider Details

I. General information

NPI: 1801974332
Provider Name (Legal Business Name): MARC ALBERT LEVINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DANIEL BURNHAM CT
SAN FRANCISCO CA
94109-5455
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT
SAN FRANCISCO CA
94109-5455
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-7056
  • Fax: 415-221-7058
Mailing address:
  • Phone: 415-221-7056
  • Fax: 415-221-7058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberG31455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: