Provider Demographics
NPI:1730349986
Name:ZENA LEVINE, M.D., MEDICAL CORPORATION
Entity type:Organization
Organization Name:ZENA LEVINE, M.D., MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-358-3582
Mailing Address - Street 1:14911 NATIONAL AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2632
Mailing Address - Country:US
Mailing Address - Phone:408-358-3580
Mailing Address - Fax:408-358-3468
Practice Address - Street 1:14911 NATIONAL AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2632
Practice Address - Country:US
Practice Address - Phone:408-358-3580
Practice Address - Fax:408-358-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46798207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty