Organization
BRUCE D. LEVINE, D.P.M., PROFESSIONAL CORPORATION
Active
Parent organization
BRUCE D. LEVINE, D.P.M., PROFESSIONAL CORPORATION
Other names
Harbor Foot & Ankle Podiatric Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRUCE D. LEVINE, D.P.M., PROFESSIONAL CORPORATION
Authorized official
BRUCE D. LEVINE DPM (OWNER)
(310) 548-1191
Entity
Organization
Contact information
Practice address
1360 W 6TH ST, SUITE 150, WEST BUILDING, SAN PEDRO, CA 90732-3514
(310) 548-1191
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 100, LOS ANGELES, CA 90077-1726
(310) 943-4180
(888) 431-8819
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
E3485
CA
Other
Enumeration date
06/17/2015
Last updated
10/05/2015
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