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Individual

DR. FREDERICK LEVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
438 W LAS TUNAS DR, SAN GABRIEL, CA 91776-1216
(626) 289-5454
Mailing address
FILE 57430, LOS ANGELES, CA 90074-0001
(800) 819-2424

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G40115
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G401150
BLUE SHIELD
05
00G401150
CA
01
G40115
BLUE CROSS
CA
Enumeration date
06/09/2006
Last updated
12/14/2007
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