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General NPI Number Information
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NPI Number | 1114438843
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Entity Type | Organization
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Legal Business Name | STELLA LEVIN, O.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 10/20/2017
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Provider Practice Location Address
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Address Line | 38069 MARTHA AVE STE 200
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City | FREMONT
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State | CA
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Zip | 94536-3815
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Country | US
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Telephone | 510-791-5272
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Fax |
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Provider Business Mailing Address
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Address Line | 38069 MARTHA AVE STE 200
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City | FREMONT
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State | CA
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Zip | 94536-3815
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Country | US
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Telephone | 510-791-5272
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. STELLA LEVIN
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Credential | OD
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Telephone | 415-531-6316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12429T
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License Number State | CA
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