Healthcare Provider Details

I. General information

NPI: 1871666776
Provider Name (Legal Business Name): VERA MARIE MUENSCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAPLE AVE
LOS ANGELES CA
90013-1511
US

IV. Provider business mailing address

330 E LIVE OAK AVE
ARCADIA CA
91006-5617
US

V. Phone/Fax

Practice location:
  • Phone: 213-430-6700
  • Fax: 213-895-6266
Mailing address:
  • Phone: 626-821-5858
  • Fax: 626-821-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberC50786
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: