Individual ProviderPauline YiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1245 16th St Ste 125, Santa Monica, CA 90404-1240(310) 899-7566PECOS EnrollmentBased on the most recent information from CMS, provider Pauline Yi 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 5 days ago.Profile DetailsProvider ID1114284171Provider TypeIndividualFull NameYi, PaulineGenderFemaleSole ProprietorNoEnumeration Date4/16/2012Last Updated6/25/2019Contact InformationPractice LocationPractice Address1245 16th St Ste 125, Santa Monica, CA 90404-1240Phone(310) 899-7566FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA155026CaliforniaCode207RR0500XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA155026CaliforniaCode2080P0216XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseA155026California