Provider Demographics
NPI:1578650016
Name:MERMAN, JAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:H
Last Name:MERMAN
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 1:5901 W OLYMPIC BLVD STE 507
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4670
Mailing Address - Country:US
Mailing Address - Phone:323-917-5183
Mailing Address - Fax:323-917-5190
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 507
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4670
Practice Address - Country:US
Practice Address - Phone:323-917-5183
Practice Address - Fax:323-917-5190
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6357282084N0400X
CAG357282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G357280Medicaid
CAG35728Medicare ID - Type Unspecified
CA00G357280Medicaid