Provider Demographics
NPI:1548449770
Name:LORI A LEVI M.D.
Entity type:Organization
Organization Name:LORI A LEVI M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-358-1970
Mailing Address - Street 1:51 N 5TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3711
Mailing Address - Country:US
Mailing Address - Phone:626-358-1970
Mailing Address - Fax:626-358-1971
Practice Address - Street 1:51 N 5TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3711
Practice Address - Country:US
Practice Address - Phone:626-358-1970
Practice Address - Fax:626-358-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67252207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18070Medicare PIN