Provider Demographics
NPI:1053323626
Name:LEVY, HOWARD PHILLIP (DO)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:PHILLIP
Last Name:LEVY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57370 29 PALMS HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2900
Mailing Address - Country:US
Mailing Address - Phone:760-369-0069
Mailing Address - Fax:760-369-8210
Practice Address - Street 1:57370 29 PALMS HWY STE 203
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2900
Practice Address - Country:US
Practice Address - Phone:760-369-0069
Practice Address - Fax:760-369-8210
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4148207Q00000X, 208D00000X, 207N00000X, 207R00000X, 207QA0505X, 207QG0300X, 207QS1201X, 207QS0010X, 207RC0000X, 207RE0101X, 207RG0300X, 207RR0500X, 207RS0012X, 208VP0000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A41480OtherPIN
CA020A41480OtherPIN