MEDICARE: ERIC M LEVANDER 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	2084P0800X	Psychiatry Physician	A72968	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	:	1992736904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC M LEVANDER MD

Provider Business Mailing Address
First Line	:	9009 BEVERLY BLVD STE 105
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-2424
Country	:	US
Telephone Number	:	310-499-4644
Fax Number	:	319-499-4699

Provider Business Practice Location Address
First Line	:	9009 BEVERLY BLVD STE 105
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-2424
Country	:	US
Telephone Number	:	310-499-4644
Fax Number	:	310-499-4699

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/30/2021

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