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General NPI Number Information
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NPI Number | 1265992168
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Entity Type | Individual
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Provider Name | JOSHUA LEVY
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 3901 H ST APT 3
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City | SACRAMENTO
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State | CA
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Zip | 95819-2753
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Country | US
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Telephone | 707-375-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 5716 FOLSOM BLVD STE 142
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City | SACRAMENTO
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State | CA
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Zip | 95819-4608
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Country | US
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Telephone |
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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 | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | A180121
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A180121
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License Number State | CA
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