Organization
GARY D. LEVINSON M.D., INC.
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
4282 GENESEE AVE, SUITE 102, SAN DIEGO, CA 92117-4946
(858) 430-1651
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A54580
CA
Other
Enumeration date
02/09/2007
Last updated
06/14/2013
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