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General NPI Number Information
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NPI Number | 1184617813
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Entity Type | Individual
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Provider Name | MICHAEL JAY LEVINE M. D.
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Gender | Male
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 914 W CENTER AVE
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City | VISALIA
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State | CA
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Zip | 93291-5916
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Country | US
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Telephone | 559-625-5833
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Fax | 559-625-5418
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Provider Business Mailing Address
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Address Line | 914 W CENTER AVE
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City | VISALIA
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State | CA
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Zip | 93291-5916
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Country | US
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Telephone | 559-625-5833
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Fax | 559-625-5418
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G18859
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License Number State | CA
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