Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | C37940 | CA |
NPI | 1043280217 |
---|---|
Provider Name | Lois R Levine |
First Address | Greenbrae, CA 94904 |
Second Address | Greenbrae, CA 94904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C379400 | (05) | CA |
A36799 | (02) |