Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A79214 | CA |
NPI | 1003035841 |
---|---|
Provider Name | Dr. Marc D Levy |
First Address | Los Angeles, CA 90049-5555 |
Second Address | Los Angeles, CA 90059-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 14/10/2021 |