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NPI Code Detail

MEDICARE: OFFICE OF ALAN LEVENTHAL P.C.

MEDICARE: OFFICE OF ALAN LEVENTHAL P.C.
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
1332H00000XEyewear SupplierSL5153CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CA6075OTHERCAEYEMED

General Provider Information

NPI Number : 1598057879
Entity Type Code : Organization
Provider Name (Legal Business Name) : OFFICE OF ALAN LEVENTHAL P.C.
Provider Business Mailing Address
First Line : 1103 FAIR OAKS AVE
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-3311
Country : US
Telephone Number : 626-441-0770
Fax Number : 626-441-0990
Provider Business Practice Location Address
First Line : 1103 FAIR OAKS AVE
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-3311
Country : US
Telephone Number : 626-441-0770
Fax Number : 626-441-0990
Authorized Official
Title or Position : MANAGER
Name : MR. BEN LU
Credential :
Telephone Number : 818-957-8942
Provider Enumeration Date : 05/05/2011
Last Update Date : 05/05/2011

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Practice Location Address:
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Practice Fax: 626-441-0990

Directions to “OFFICE OF ALAN LEVENTHAL P.C. ” Practice Location

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