Basic Information
Provider Information
NPI: 1346407491
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVIN-SHOHAT
FirstName: ANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1510 4TH ST
Address2: SUITE 1
City: BERKELEY
State: CA
PostalCode: 947101717
CountryCode: US
TelephoneNumber: 5105258980
FaxNumber: 5105258982
Practice Location
Address1: 1510 4TH ST
Address2: SUITE 1
City: BERKELEY
State: CA
PostalCode: 947101717
CountryCode: US
TelephoneNumber: 5105258980
FaxNumber: 5105258982
Other Information
ProviderEnumerationDate: 05/16/2008
LastUpdateDate: 05/16/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X20A10357CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home