Organization
ELLYN LEVINE, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLYN LEVINE MD (INCORPORATOR)
(858) 663-1671
Entity
Organization
Contact information
Practice address
5290 BALTIMORE DR, LA MESA, CA 91942-2080
(619) 567-6914
(619) 567-8228
Mailing address
3830 VALLEY CENTRE DR # 705-306, SAN DIEGO, CA 92130-3320
(619) 567-6914
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
G86297
CA
Other
Enumeration date
10/14/2013
Last updated
05/31/2016
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