MEDICARE: DR. EDWARD O LEVENTEN 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	207X00000X	Orthopaedic Surgery Physician	C26221	CA

General Provider Information

NPI Number	:	1548315211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD O LEVENTEN MD

Provider Business Mailing Address
First Line	:	600 ST PAUL AVE
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-2038
Country	:	US
Telephone Number	:	213-250-9900
Fax Number	:	213-250-9380

Provider Business Practice Location Address
First Line	:	600 ST PAUL AVE
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-2038
Country	:	US
Telephone Number	:	213-250-9900
Fax Number	:	213-250-9380

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	03/26/2008

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