Provider Demographics
NPI:1528014685
Name:LEVITAN, DEAN BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:BRIAN
Last Name:LEVITAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1700 S COURT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-4929
Mailing Address - Country:US
Mailing Address - Phone:559-741-1202
Mailing Address - Fax:559-741-0123
Practice Address - Street 1:1700 S COURT ST
Practice Address - Street 2:SUITE B
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4929
Practice Address - Country:US
Practice Address - Phone:559-741-1202
Practice Address - Fax:559-741-0123
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG47194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G471940Medicaid
CA00G471940Medicare ID - Type Unspecified
CA00G471940Medicaid