Organization
JEREMY LEVENSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY E LEVENSON M.D. (PRESIDENT)
(310) 477-5558
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90025-1708
(310) 477-5558
(310) 477-7281
Mailing address
11645 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90025-1708
(310) 477-5558
(310) 477-7281
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A22502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A225020
—
CA
01
—
P00178725
RAILROAD MEDICARE
CA
Enumeration date
02/14/2007
Last updated
06/18/2010
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