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Individual

AISHA MARIA VAN PRATT LEVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2300
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 906-4623
(619) 269-0083

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A184947
CA
207Q00000X
Family Medicine Physician
MD61283832
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A184947
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
04/02/2019
Last updated
11/27/2023
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