MEDICARE: DR. SARAH ELIZABETH VERMUELE DC

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	111N00000X	Chiropractor	28440	CA

General Provider Information

NPI Number	:	1528217684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ELIZABETH VERMUELE DC

Provider Business Mailing Address
First Line	:	3315 GLENDALE BLVD
Second Line	:	#1
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1812
Country	:	US
Telephone Number	:	323-376-5985
Fax Number	:	323-315-4213

Provider Business Practice Location Address
First Line	:	3315 GLENDALE BLVD
Second Line	:	#1
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1812
Country	:	US
Telephone Number	:	323-376-5985
Fax Number	:	323-315-4213

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

Provider Enumeration Date	:	09/13/2008
Last Update Date	:	09/13/2008

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