Individual
BRUCE D LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1360 W 6TH ST, 150W, SAN PEDRO, CA 90732-3514
(310) 548-1191
(310) 548-4007
Mailing address
1360 W 6TH ST, 150W, SAN PEDRO, CA 90732-3514
(310) 548-1191
(310) 548-4007
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3485
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E34850
—
CA
Enumeration date
04/30/2007
Last updated
06/20/2016
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