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NPI Code Detail

MEDICARE: DEBRA LEE POORMAN

MEDICARE: DEBRA LEE POORMAN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor01-093276CA

General Provider Information

NPI Number : 1043596612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LEE POORMAN
Provider Business Mailing Address
First Line : 909 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1326
Country : US
Telephone Number : 310-614-6200
Fax Number : 310-450-2024
Provider Business Practice Location Address
First Line : 909 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1326
Country : US
Telephone Number : 310-614-6200
Fax Number : 310-450-2024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2011
Last Update Date : 10/27/2011

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Directions to “ DEBRA LEE POORMAN ” Practice Location

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