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Organization
ENT MEDICAL AND SURGICAL CARE A PROFESSIONAL CORPORATION
Active
Organization
ENT MEDICAL AND SURGICAL CARE A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JACKSON LEVIN MD (CEO)
(805) 439-3250
Entity
Organization
Contact information
Practice address
100 CASA ST STE B, SAN LUIS OBISPO, CA 93405-8803
(805) 439-3250
(888) 359-6465
Mailing address
100 CASA ST STE B, SAN LUIS OBISPO, CA 93405-8803
(805) 439-3250
(888) 359-6465
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
Other
Enumeration date
12/16/2018
Last updated
12/17/2018
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