Organization Active NPI

ENT Medical and Surgical Care

  • Otolaryngology Physician
  • San Luis Obispo, CA
National Provider Identifier
1033680996
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT MEDICAL AND SURGICAL CARE
Practice address
100 Casa St Ste B100
San Luis Obispo, CA 93405-1883
Phone
(805) 439-3250
Fax
(855) 866-3725
NPI assigned
Dec 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Levin, MDNPI 1366679516
Title
Ceo
Phone
(805) 439-3250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

100 Casa St Ste B100
San Luis Obispo, CA 93405-1883

Mailing address

100 Casa St Ste B100
San Luis Obispo, CA 93405-1883
Phone (805) 439-3250

Other identifiers 1

IdentifierTypeStateIssuer
1366679516MedicaidCA

National Provider Directory

National Provider Directory

Locations

100 Casa St
Ste B100
San Luis Obispo, CA 93405
Phone (805) 439-3250

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1033680996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CASA ST STE B100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051883",
            "telephone_number": "805-439-3250",
            "fax_number": "855-866-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CASA ST STE B100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051883",
            "telephone_number": "805-439-3250",
            "fax_number": "855-866-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT MEDICAL AND SURGICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-439-3250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366679516",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.