Provider Demographics
NPI:1316011984
Name:YAREMA, VALERI (MD)
Entity Type:Individual
Prefix:
First Name:VALERI
Middle Name:
Last Name:YAREMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 20TH ST STE 360
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2087
Mailing Address - Country:US
Mailing Address - Phone:310-453-7856
Mailing Address - Fax:310-453-1031
Practice Address - Street 1:1301 20TH ST STE 360
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2087
Practice Address - Country:US
Practice Address - Phone:310-453-7856
Practice Address - Fax:310-453-1031
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA761482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI23572Medicare UPIN
CAA76148Medicare ID - Type Unspecified