MEDICARE: MARK E LEVINE MD

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	207Q00000X	Family Medicine Physician	L3728	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285790170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK E LEVINE MD

Provider Business Mailing Address
First Line	:	6255 W SUNSET BLVD FL 21
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7422
Country	:	US
Telephone Number	:	323-860-5200
Fax Number	:	323-467-7119

Provider Business Practice Location Address
First Line	:	7400 FANNIN ST STE 1118
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1936
Country	:	US
Telephone Number	:	713-799-8994
Fax Number	:	713-799-9931

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	05/02/2024

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Directions to “ MARK E LEVINE MD” Practice Location

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