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General NPI Number Information
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NPI Number | 1750608204
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Entity Type | Individual
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Provider Name | LAURA CHRISTINE LEVITT MD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 12/06/2017
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Provider Practice Location Address
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Address Line | 147 N BRENT ST
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City | VENTURA
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State | CA
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Zip | 93003-2809
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Country | US
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Telephone | 805-652-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 3116 W MARCH LN #200
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City | STOCKTON
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State | CA
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Zip | 95219-2369
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Country | US
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Telephone | 209-473-6555
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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 | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | A141214
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A141214
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License Number State | CA
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