Healthcare Provider Details

I. General information

NPI: 1235102153
Provider Name (Legal Business Name): MICHAEL B LEVEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23101 SHERMAN PL SUITE110
WEST HILLS CA
91307-2003
US

IV. Provider business mailing address

23101 SHERMAN PL SUITE110
WEST HILLS CA
91307-2003
US

V. Phone/Fax

Practice location:
  • Phone: 818-702-8800
  • Fax: 818-702-0080
Mailing address:
  • Phone: 818-702-8800
  • Fax: 818-702-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG34681
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG34681
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberG34681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: