Physicians

Physician referral.

Name: North County Orthopedic Medical Group
Address: 8929 University Center Ln, Ste 100, San Diego, CA, 92122, US
Telephone: (858) 457-4040
Price range: $$

Refer a patient to Dr. Levine. Send basic clinical information and we'll take it from there.

Call (858) 457-4040 All forms

Referring provider

Referring physician *

Practice / group *

NPI

Fax

Phone *

Email *

Referrer type *

Patient

Patient name *

Date of birth *

Patient phone *

Patient email

Working diagnosis *

Body part *

Urgency *

Imaging available

Reason for referral / relevant history *

Attach referral / records (optional)

Do not include sensitive medical information beyond what's asked. For medical emergencies, call 911. No information is stored on your device. Submissions are transmitted securely to our intake system.

I agree to receive emails from North County Orthopedic Medical Group about my request (confirmations and follow-up).I agree to receive text messages from North County Orthopedic Medical Group about my request. Msg & data rates may apply. Reply STOP to opt out.

Se habla español · Workers' Comp & Longshore accepted · Most major insurance plans