Healthcare Provider Details
I. General information
NPI: 1578827077
Provider Name (Legal Business Name): HOPE MARIAN VERMAIRE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/28/2012
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 TORRANCE BLVD STE 600
TORRANCE CA
90503-4523
US
IV. Provider business mailing address
5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US
V. Phone/Fax
- Phone: 310-316-4373
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 5101020058 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | DO175806 |
| License Number State | OR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 20A16705 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: