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General NPI Number Information
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NPI Number | 1184629859
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Entity Type | Individual
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Provider Name | BARBARA SUSAN LEVY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 1485 DEER HILL CT
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City | LA JOLLA
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State | CA
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Zip | 92037-7429
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Country | US
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Telephone | 253-740-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 1485 DEER HILL CT
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City | LA JOLLA
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State | CA
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Zip | 92037-7429
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Country | US
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Telephone | 253-740-7350
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MD00019274
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G43461
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License Number State | CA
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