Provider Demographics
NPI:1881849404
Name:MARK DAVID LEVINEMD, WALNUT CREEK, PC
Entity type:Organization
Organization Name:MARK DAVID LEVINEMD, WALNUT CREEK, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-486-1182
Mailing Address - Street 1:2081 ARENA BLVD
Mailing Address - Street 2:SUITE: 160
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2309
Mailing Address - Country:US
Mailing Address - Phone:916-285-8977
Mailing Address - Fax:916-285-0338
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:SUITE: 2-208
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-299-9033
Practice Address - Fax:925-299-9030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY PSYCHIATRY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty