Healthcare Provider Details

I. General information

NPI: 1487737839
Provider Name (Legal Business Name): TOPAZ LEVENBERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOPAZ LEV-ON M.D.

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 KIELY BLVD
SANTA CLARA CA
95051-5329
US

IV. Provider business mailing address

700 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA83608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: