Provider Demographics
NPI:1578827077
Name:VERMAIRE, HOPE MARIAN (DO)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:MARIAN
Last Name:VERMAIRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 TORRANCE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4523
Practice Address - Country:US
Practice Address - Phone:310-316-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020058207V00000X
ORDO175806207V00000X
CA20A16705207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR161133OtherNORTH BEND MEDICAL CENTER GROUP MEDICAID
OR93-0635514OtherNORTH BEND MEDICAL CENTER GROUP TAX ID
OR1407812365OtherNORTH BEND MEDICAL CENTER GROUP NPI
OR500711497Medicaid
ORR0000WFBTVOtherNORTH BEND MEDICAL CENTER GROUP MEDICARE
ORR189285Medicare PIN