1538402813 NPI number — ERIC G. LEVY MEDICAL CORPORATION

Table of content: DR. JEAN ROBERT DARBOUZE MD (NPI 1639201510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538402813 NPI number — ERIC G. LEVY MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ERIC G. LEVY MEDICAL 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:
ERIC G. LEVY, M.D.
Provider Other Organization Name Type Code:
4
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:
1538402813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 EAST PLAZA DR
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
SANTA MARIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93454-6955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-922-2119
Provider Business Mailing Address Fax Number:
805-349-8283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 EAST PLAZA DR.
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93454-6955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-922-2119
Provider Business Practice Location Address Fax Number:
805-349-8283
Provider Enumeration Date:
04/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LEVY
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
GEORGE
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
805-922-2119

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A70946 , 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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