MEDICARE: DR. JAN H MERMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	635728	OH
2	2084N0400X	Neurology Physician	G35728	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578650016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAN H MERMAN M.D.

Provider Business Mailing Address
First Line	:	5901 W OLYMPIC BLVD STE 507
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4670
Country	:	US
Telephone Number	:	323-917-5183
Fax Number	:	323-917-5190

Provider Business Practice Location Address
First Line	:	5901 W OLYMPIC BLVD STE 507
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4670
Country	:	US
Telephone Number	:	323-917-5183
Fax Number	:	323-917-5190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	09/25/2018

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Directions to “ DR. JAN H MERMAN M.D.” Practice Location

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