Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A44379 | CA |
N | 111NI0900X | Internist | A44379 | CA |
Y | 207RG0300X | Geriatric Medicine | A44379 | CA |
NPI | 1124084579 |
---|---|
Provider Name | Marcie Lynn Levine |
First Address | San Jose, CA 95128-2604 |
Second Address | San Jose, CA 95116-1406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 14/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A443790 | (05) | CA |
E25149 | (02) | CA |