Provider Demographics
NPI:1285695130
Name:LEVAS PHYSICAL & OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:LEVAS PHYSICAL & OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-455-1195
Mailing Address - Street 1:9404 GENESEE AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-455-1195
Mailing Address - Fax:858-455-7101
Practice Address - Street 1:9404 GENESEE AVE.
Practice Address - Street 2:SUITE 310
Practice Address - City:LAJOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-455-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W14568AMedicare ID - Type Unspecified
W14568FMedicare ID - Type Unspecified
W14568DMedicare ID - Type Unspecified
W14568Medicare ID - Type Unspecified
W14568CMedicare ID - Type Unspecified
W14568BMedicare ID - Type Unspecified
W14568EMedicare ID - Type Unspecified