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General NPI Number Information
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NPI Number | 1003890971
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Entity Type | Individual
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Provider Name | HENRY LEVENSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 100 W CALIFORNIA BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3010
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Country | US
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Telephone | 626-256-6010
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Fax | 855-266-6110
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Provider Business Mailing Address
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Address Line | PO BOX 1180
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City | CLAREMONT
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State | CA
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Zip | 91711-1180
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Country | US
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Telephone | 626-256-6010
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Fax | 855-266-6110
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | G34680
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License Number State | CA
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