Provider Demographics
NPI:1427139591
Name:LEVIN, MICHAEL HARLAN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HARLAN
Last Name:LEVIN
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 1:2311 LOVERIDGE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565
Mailing Address - Country:US
Mailing Address - Phone:925-431-2600
Mailing Address - Fax:
Practice Address - Street 1:2311 LOVERIDGE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565
Practice Address - Country:US
Practice Address - Phone:925-431-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0169182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG016918OtherCALIF STATE LICENSE NUMBE
CAG016918OtherCALIF STATE LICENSE NUMBE