MEDICARE: LUWAM GEBREMUSIE SEMERE

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	174400000X	Specialist	A111761	CA
2	207V00000X	Obstetrics & Gynecology Physician	A111761	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	:	1740315324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUWAM GEBREMUSIE SEMERE

Provider Business Mailing Address
First Line	:	200 MEDICAL PLZ
Second Line	:	STE 430
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-0001
Country	:	US
Telephone Number	:	310-794-7274
Fax Number	:

Provider Business Practice Location Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	STE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:	310-794-7274
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	12/14/2021

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Directions to “ LUWAM GEBREMUSIE SEMERE ” Practice Location

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