1427060060 NPI number — GARY A LEVINSON MD A PROFESSIONAL CORPORATION

Table of content: MICHAEL JAMES BRYANT PHARM.D. (NPI 1154807030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427060060 NPI number — GARY A LEVINSON MD A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GARY A LEVINSON MD A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427060060
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
340 S. FARRELL DR
Provider Second Line Business Mailing Address:
A208
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92262-7931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-773-9252
Provider Business Mailing Address Fax Number:
760-773-9236

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 S. FARRELL DR
Provider Second Line Business Practice Location Address:
A208
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-7931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-773-9252
Provider Business Practice Location Address Fax Number:
760-773-9236
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVINSON
Authorized Official First Name:
GARY
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
760-773-9252

Provider Taxonomy Codes

  • Taxonomy code: 2084P0805X , with the licence number:  G15765 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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