Provider Demographics
NPI:1972530301
Name:LEVINE, STEVEN ELIOT (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ELIOT
Last Name:LEVINE
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 1:26800 DEGAS LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1833
Mailing Address - Country:US
Mailing Address - Phone:661-312-3338
Mailing Address - Fax:661-463-5540
Practice Address - Street 1:26800 DEGAS LN
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1833
Practice Address - Country:US
Practice Address - Phone:661-312-3338
Practice Address - Fax:661-463-5540
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG402992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB57644Medicare UPIN
CAG40299Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER