1841626447 NPI number — MARK DAVID LEVINE, MD PSYCHIATRISTS PROFESSIONAL CORPORATION

Table of content: (NPI 1841626447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841626447 NPI number — MARK DAVID LEVINE, MD PSYCHIATRISTS PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARK DAVID LEVINE, MD PSYCHIATRISTS 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:
6
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:
1841626447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3835 N FREEWAY BLVD
Provider Second Line Business Mailing Address:
100
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95834-1928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-576-7898
Provider Business Mailing Address Fax Number:
916-285-0338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2801 NETWORK BLVD STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-1880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-576-7898
Provider Business Practice Location Address Fax Number:
916-285-0338
Provider Enumeration Date:
09/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SPAULDING
Authorized Official First Name:
JASMINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PAYOR RELATIONS SUPERVISOR
Authorized Official Telephone Number:
916-567-7893

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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