MEDICARE: JULIET LA MERS

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	207P00000X	Emergency Medicine Physician	A52640	CA
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	A052640	CA
3	207Q00000X	Family Medicine Physician	A052640	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	:	1073657367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIET LA MERS

Provider Business Mailing Address
First Line	:	PO BOX 45680
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94145-0680
Country	:	US
Telephone Number	:	530-626-2787
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 MARSHALL WAY
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-5721
Country	:	US
Telephone Number	:	530-621-7965
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	02/22/2021

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Directions to “ JULIET LA MERS ” Practice Location

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