Provider Demographics
NPI:1548315211
Name:LEVENTEN, EDWARD O (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:O
Last Name:LEVENTEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 ST PAUL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2038
Mailing Address - Country:US
Mailing Address - Phone:213-250-9900
Mailing Address - Fax:213-250-9380
Practice Address - Street 1:600 ST PAUL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2038
Practice Address - Country:US
Practice Address - Phone:213-250-9900
Practice Address - Fax:213-250-9380
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2008-03-26
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Provider Licenses
StateLicense IDTaxonomies
CAC26221207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A87064Medicare UPIN