Healthcare Provider Details

I. General information

NPI: 1275452997
Provider Name (Legal Business Name): LEVWELL HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 89TH AVE
MERRILLVILLE IN
46410
US

IV. Provider business mailing address

15910 VENTURA BLVD STE 1701
ENCINO CA
91436-2816
US

V. Phone/Fax

Practice location:
  • Phone: 310-399-6863
  • Fax:
Mailing address:
  • Phone: 310-399-6863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ZAZA U ATANELOV
Title or Position: OWNER
Credential: MD
Phone: 310-399-6863