Provider Demographics
NPI:1306876883
Name:LEVINSON, MICHAEL URI (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:URI
Last Name:LEVINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94011-0351
Mailing Address - Country:US
Mailing Address - Phone:415-596-1151
Mailing Address - Fax:650-727-0551
Practice Address - Street 1:25 EDWARDS CT
Practice Address - Street 2:STE 101
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2429
Practice Address - Country:US
Practice Address - Phone:415-596-1151
Practice Address - Fax:650-727-0551
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA636542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHD085ZOtherPTAN
CA00A636540Medicare PIN
CAG62135Medicare UPIN