Individual
MICHAEL LEWIS LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2540 EAST ST, CONCORD, CA 94520-1906
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G30069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG300690
—
CA
01
—
OOG300691
BLUE SHIELD
CA
Enumeration date
11/03/2005
Last updated
12/08/2008
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