Individual
FRED LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
7910 FROST ST, STE 200, SAN DIEGO, CA 92123-2771
(619) 543-7800
Mailing address
3020 CHILDRENS WAY, MC5110, SAN DIEGO, CA 92123-4223
(619) 543-7800
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
G65341
CA
207SG0202X
Clinical Biochemical Genetics Physician
G65341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G653410
—
CA
Enumeration date
11/14/2006
Last updated
05/09/2014
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