MEDICARE: MR. CHRIS LEVENTIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225000000X	Orthotic Fitter

General Provider Information

NPI Number	:	1083801583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS LEVENTIS

Provider Business Mailing Address
First Line	:	3606 OCEAN RANCH BLVD
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-2669
Country	:	US
Telephone Number	:	760-231-8189
Fax Number	:

Provider Business Practice Location Address
First Line	:	3606 OCEAN RANCH BLVD
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-2669
Country	:	US
Telephone Number	:	760-231-8189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	09/19/2019

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Directions to “ MR. CHRIS LEVENTIS ” Practice Location

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