Individual ProviderDiana KaedingNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Med Plaza Suite 465, Los Angeles, CA 90095-5313(310) 825-5510PECOS EnrollmentBased on the most recent information from CMS, provider Diana Kaeding is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:00 PM.Profile DetailsProvider ID1164977229Provider TypeIndividualFull NameKaeding, DianaCredentialNPGenderFemaleSole ProprietorNoEnumeration Date8/18/2016Last Updated3/17/2018Contact InformationPractice LocationPractice Address200 Med Plaza Suite 465, Los Angeles, CA 90095-5313Phone(310) 825-5510FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 825-5510FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95003035California