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General NPI Number Information
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NPI Number | 1215963582
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Entity Type | Organization
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Legal Business Name | JON A LE LEVIER MD INC
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 2067 W VISTA WAY SUITE 200
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City | VISTA
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State | CA
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Zip | 92083-6031
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Country | US
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Telephone | 760-941-9844
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Fax | 760-630-5716
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Provider Business Mailing Address
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Address Line | 2067 W VISTA WAY SUITE 200
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City | VISTA
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State | CA
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Zip | 92083-6031
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Country | US
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Telephone | 760-941-9844
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Fax | 760-630-5716
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Authorized Official
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Title or Position | ANNE BILLETER
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Name | DR. JON A LE LEVIER
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Credential | M.D. INC
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Telephone | 760-941-9844
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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 | G39907
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License Number State | CA
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