Basic Information
| Provider Information | |||||||||
| NPI: | 1306378781 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVIN | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3126 ROBERTS AVE | ||||||||
| Address2: | |||||||||
| City: | CULVER CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902327415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103479703 | ||||||||
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| Practice Location | |||||||||
| Address1: | 924 WESTWOOD BOULEVARD | ||||||||
| Address2: | STE 300 UCLA EMERGENCY MEDICINE; | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107940785 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2017 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A159229 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.