MEDICARE: WENDY JO LEVIN 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	207RH0003X	Hematology & Oncology Physician	MD00039665	WA
2	207RH0003X	Hematology & Oncology Physician	A72488	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	280200	OTHER		INTERNAL ID-MOTOR VEHICLE ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649360595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY JO LEVIN MD

Provider Business Mailing Address
First Line	:	PO BOX 8470
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067-8470
Country	:	US
Telephone Number	:	858-756-7976
Fax Number	:	877-481-5208

Provider Business Practice Location Address
First Line	:	10646 SCIENCE CENTER DR
Second Line	:	CB10
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1150
Country	:	US
Telephone Number	:	858-622-8019
Fax Number	:	877-481-5208

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	10/31/2008

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