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General NPI Number Information
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NPI Number | 1114108768
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Entity Type | Organization
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Legal Business Name | SCOTT D LEVENSON, MD
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 1000 LAUREL ST
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City | SAN CARLOS
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State | CA
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Zip | 94070-3939
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Country | US
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Telephone | 650-596-8800
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Fax | 650-596-8802
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Provider Business Mailing Address
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Address Line | PO BOX 7625
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City | MENLO PARK
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State | CA
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Zip | 94026-7625
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Country | US
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Telephone | 650-596-8800
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Fax | 650-596-8802
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT D LEVENSON
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Credential | MD
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Telephone | 650-596-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A98824
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G71807
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License Number State | CA
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