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General NPI Number Information
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NPI Number | 1205915725
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Entity Type | Individual
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Provider Name | MICHEL F. LEVESQUE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 444 S SAN VICENTE BLVD STE 800
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City | LOS ANGELES
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State | CA
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Zip | 90048-4174
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Country | US
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Telephone | 310-659-6633
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Fax | 310-659-6631
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Provider Business Mailing Address
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Address Line | 269 S BEVERLY DR STE 320
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3851
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Country | US
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Telephone | 310-659-6633
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Fax | 310-659-6631
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | G59708
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License Number State | CA
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