MEDICARE: GAIL LEVEE

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	G60173	CA
2	207RP1001X	Pulmonary Disease Physician	G60173	CA

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	:	1578500021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL LEVEE

Provider Business Mailing Address
First Line	:	3521 LOMITA BLVD STE 103
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-5041
Country	:	US
Telephone Number	:	310-534-9131
Fax Number	:	310-534-9132

Provider Business Practice Location Address
First Line	:	510 N PROSPECT AVE
Second Line	:	304
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3028
Country	:	US
Telephone Number	:	310-372-8005
Fax Number	:

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/06/2015

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Directions to “ GAIL LEVEE ” Practice Location

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