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Kathleen Marie Carlos

Student in an Organized Health Care Education/Training Program

Student, Health Care

3800 W Chapman Ave Ste 500, Orange, CA 92868-1638

PECOS Enrollment

This provider is enrolled in PECOS as KATHLEEN CARLOS.

Based on the most recent information from CMS, provider Kathleen Marie Carlos 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 yesterday at 11:26 AM.

Profile Details

Provider ID
1043905755
Provider Type
Individual
Full Name
Carlos, Kathleen Marie
Title
Dr.
Credential
MD, PHD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/7/2023
Last Updated
8/13/2023

Contact Information

Practice Location

3800 W Chapman Ave Ste 500, Orange, CA 92868-1638

(949) 610-9598

Unlisted Fax

Mailing Location

3800 W Chapman Ave Ste 500, Orange, CA 92868-1638

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Kathleen Marie Carlos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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