Mark David Levine MD, Fort Bragg Professional Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MARK DAVID LEVINE MD, FORT BRAGG PROFESSIONAL CORPORATION

Practice address

700 River Dr
Fort Bragg, CA 95437-5403

Phone

(916) 285-8977

Fax

(916) 285-0338

NPI assigned

Oct 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark David Levine, MD

Title

President

Phone

(415) 785-4636

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255305600000",
    "number": "1447585245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 ARENA BLVD",
            "address_2": "SUITE 160",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958342309",
            "telephone_number": "916-285-8971",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RIVER DR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "916-285-8977",
            "fax_number": "916-285-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK DAVID LEVINE MD, FORT BRAGG PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-785-4636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynette Kline O.D.
• Suzanna Macias, RD
• William Matthew Mahon, M.D.
• Michele Maley
• Erika Lynn Malsom, MFT-INTERN
• Joseph E Martin, PA
• Lucila Martinez
• Linnea Marie Matthews, FNP
• James Frederick Mattson, DDS
• Marcie Mliss Maxham, DDS

• Psychiatry Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.