# RUSS L LEVITAN MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689470122
- **Authorized official:** RUSS L LEVITAN MD (PRESIDENT)
- **Authorized official phone:** (805) 550-0445

## Contact information

- **Practice address:** 10 SANTA ROSA ST \# 201, SAN LUIS OBISPO, CA 93405-5826
- **Practice address phone:** (805) 544-7246
- **Practice address fax:** (805) 782-8097
- **Mailing address:** 1305 FILAREE WAY, ARROYO GRANDE, CA 93420-4947
- **Mailing address phone:** (805) 550-0445
- **Mailing address fax:** (805) 782-8097

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2025
- **Last updated:** 03/14/2025