Individual
ANN MARIE T LEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A44196
CA
2085R0202X
Diagnostic Radiology Physician
Primary
A44196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A441960
—
CA
01
—
HW8412
GROUP PTAN
CA
01
—
HW8412A
PTAN/LEGACY PACIFIC HOSP
CA
01
—
HW8412B
PTAN/LEGACY COMMUNITY HOSP
CA
01
—
HW881
ST MARYS PTAN
CA
Enumeration date
06/06/2006
Last updated
08/20/2018
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