MEDICARE: ANGELA MARIE SARFF

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	363LF0000X	Family Nurse Practitioner	95010172	CA

General Provider Information

NPI Number	:	1619524667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MARIE SARFF

Provider Business Mailing Address
First Line	:	1180 S SIERRA BONITA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-2550
Country	:	US
Telephone Number	:	818-416-2801
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 N LARCHMONT BLVD STE 906
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-6409
Country	:	US
Telephone Number	:	323-464-8046
Fax Number	:

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

Provider Enumeration Date	:	08/23/2019
Last Update Date	:	08/23/2019

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