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Miguel Angel Velazquez

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

757 Westwood Plz, Los Angeles, CA 90095-1804

PECOS Enrollment

This provider is enrolled in PECOS as MIGUEL VELAZQUEZ.

Based on the most recent information from CMS, provider Miguel Angel Velazquez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1023884319
Provider Type
Individual
Full Name
Velazquez, Miguel Angel
Title
Mr.
Credential
AGACNP-BC, AGCNS-BC

Gender
Male
Sole Proprietor
No
Enumeration Date
11/28/2023
Last Updated
6/3/2024

Contact Information

Practice Location

757 Westwood Plz, Los Angeles, CA 90095-1804

(310) 825-8232

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95026204 California
Code 364S00000X	Description Clinical Nurse Specialist Physician Assistants & Advanced Practice Nursing Providers	License 5077 California

Miguel Angel Velazquez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Quesada, Sharon Del Carmen

Chavarria, Allison Yumiko

Lee, David

Shin, Hannah Haesoo

Hoang, Henry

Orozco Santana, Emmanuel

Castiglione, Haley F.

Modi, Ashley Lynn

Fadely, Teresa Mahoney

Park, Amanda Elizabeth