Organization
LA PAIN AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LEVIN MD (OWNDER)
(917) 751-4299
Entity
Organization
Contact information
Practice address
14021 AMARGOSA RD, VICTORVILLE, CA 92392-6404
(917) 751-4299
Mailing address
14021 AMARGOSA RD, VICTORVILLE, CA 92392-6404
(917) 751-4299
(888) 666-4606
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245888775
—
CA
Enumeration date
10/01/2021
Last updated
10/01/2021
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