Provider Demographics
NPI:1598079436
Name:JOSHUA LEVY M.D. A PROFESSIONAL CORP
Entity type:Organization
Organization Name:JOSHUA LEVY M.D. A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-789-8848
Mailing Address - Street 1:4910 VAN NUYS BLVD
Mailing Address - Street 2:SUITE#303
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1715
Mailing Address - Country:US
Mailing Address - Phone:818-789-8848
Mailing Address - Fax:818-789-6743
Practice Address - Street 1:4910 VAN NUYS BLVD
Practice Address - Street 2:SUITE#303
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1715
Practice Address - Country:US
Practice Address - Phone:818-789-8848
Practice Address - Fax:818-789-6743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG12758207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG012758OtherPTAN #
CAG012758OtherPTAN #