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General NPI Number Information
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NPI Number | 1841595477
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Entity Type | Organization
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Legal Business Name | DOCTOR BARRY LEFKOVITCH INCORPORATED
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/16/2011
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Provider Practice Location Address
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Address Line | 227 W JANSS RD STE 315
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1848
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Country | US
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Telephone | 805-390-9974
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Fax | 818-597-8485
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Provider Business Mailing Address
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Address Line | 227 W JANSS RD STE 315
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1848
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Country | US
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Telephone | 805-390-9974
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Fax | 818-597-8485
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Authorized Official
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Title or Position | OWNER
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Name | BARRY LEFKOVITCH
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Credential | MD
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Telephone | 805-390-9974
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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 | A44733
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License Number State | CA
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