MEDICARE: RONALD M LEVIN MD INC

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1437706124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD M LEVIN MD INC

Provider Business Mailing Address
First Line	:	8158 SANTALUZ VILLAGE GRN N
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-2520
Country	:	US
Telephone Number	:	858-382-5689
Fax Number	:

Provider Business Practice Location Address
First Line	:	8881 FLETCHER PKWY STE 100
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-3128
Country	:	US
Telephone Number	:	619-698-0930
Fax Number	:	619-698-3093

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONALD MALCOLM LEVIN
Credential	:	MD
Telephone Number	:	858-382-5689

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	02/01/2022

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