Organization
ENT MEDICAL AND SURGICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LEVIN MD (CEO)
(805) 439-3250
Entity
Organization
Contact information
Practice address
100 CASA ST STE B100, SAN LUIS OBISPO, CA 93405-1883
(805) 439-3250
(855) 866-3725
Mailing address
100 CASA ST STE B100, SAN LUIS OBISPO, CA 93405-1883
(805) 439-3250
(855) 866-3725
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366679516
—
CA
Enumeration date
12/17/2018
Last updated
12/17/2018
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