Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301100627 | MI |
N | 208000000X | Pediatrician | A112337 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A112337 | CA |
NPI | 1063712594 |
---|---|
Provider Name | Jennifer Levy |
First Address | Los Angeles, CA 90010-2804 |
Second Address | Tarzana, CA 91356-3501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 11/11/2020 |