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General NPI Number Information
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NPI Number | 1316001209
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Entity Type | Organization
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Legal Business Name | EL SOL FAMILY MEDICINE PC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 2260 N ROSEMONT BLVD STE 107
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City | TUCSON
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State | AZ
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Zip | 85712-2137
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Country | US
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Telephone | 520-318-1033
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Fax | 520-318-1338
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Provider Business Mailing Address
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Address Line | 2260 N ROSEMONT BLVD STE 107
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City | TUCSON
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State | AZ
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Zip | 85712-2137
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Country | US
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Telephone | 520-318-1033
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELISSA D LEVINE
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Credential | MD
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Telephone | 520-318-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21943
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License Number State | AZ
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