Individual ProviderSeu Na ParkNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10833 Le Conte Ave, Los Angeles, CA 90095-2200(310) 825-6078PECOS EnrollmentBased on the most recent information from CMS, provider Seu Na Park is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1063816882Provider TypeIndividualFull NamePark, Seu NaTitleMs.CredentialMSN, FNP-BC, RNGenderFemaleSole ProprietorNoEnumeration Date10/22/2014Last Updated5/4/2018Contact InformationPractice LocationPractice Address10833 Le Conte Ave, Los Angeles, CA 90095-2200Phone(310) 825-6078FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 825-6078FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP95001327CaliforniaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense794846CaliforniaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP95001327California