MEDICARE: DR. HANNAH R WIRTH MD

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	207V00000X	Obstetrics & Gynecology Physician	MD61280979	WA
2	207V00000X	Obstetrics & Gynecology Physician	A164551	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	:	1972007706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANNAH R WIRTH MD

Provider Business Mailing Address
First Line	:	4900 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5800
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5800
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

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

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	07/26/2023

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