Provider Demographics
NPI:1336230127
Name:LEVIANT, CURTIS D (DPM)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:D
Last Name:LEVIANT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 LAUREL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3949
Mailing Address - Country:US
Mailing Address - Phone:650-593-8083
Mailing Address - Fax:650-593-9145
Practice Address - Street 1:961 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3949
Practice Address - Country:US
Practice Address - Phone:650-593-8083
Practice Address - Fax:650-593-9145
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3224213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3224OtherSTATE LICENCE
CA000E32240Medicare PIN
CAT11586Medicare UPIN