Individual provider · NPI-1

Levi Martin

Physician Assistant · Moorpark, CA

NPI number1255044251
StatusActive
Last updated in NPPESMar 4, 2026

Details

NPI
1255044251
Entity type
Individual (NPI-1)
Name
Levi Martin
Sex
Male
Sole proprietor
No
Enumeration date
Jan 4, 2023
Certification date
Mar 4, 2026
Last updated
Mar 4, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant66820CAYes

Practice location

145 Park Ln Ste 120
Moorpark, CA 93021-2116

Phone 805-372-2886

Mailing address

145 Park Ln Ste 120
Moorpark, CA 93021-2116

Phone 805-372-2886

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