Individual ProviderBakheng PhengInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822(323) 783-4892PECOS EnrollmentBased on the most recent information from CMS, provider Bakheng Pheng 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 2 days ago.Profile DetailsProvider ID1083932024Provider TypeIndividualFull NamePheng, BakhengCredentialM.D.GenderMaleSole ProprietorYesEnumeration Date5/14/2010Last Updated11/4/2021Contact InformationPractice LocationPractice Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822Phone(323) 783-4892FaxUnlisted FaxMailing LocationMailing Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822Phone(323) 783-4892FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA112415California