Individual ProviderHolly DieuInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1250 16th St Ste 125, Santa Monica, CA 90404-1249(310) 315-8900(310) 301-8707PECOS EnrollmentBased on the most recent information from CMS, provider Holly Dieu 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 ID1184155285Provider TypeIndividualFull NameDieu, HollyCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date3/21/2017Last Updated1/13/2023Contact InformationPractice LocationPractice Address1250 16th St Ste 125, Santa Monica, CA 90404-1249Phone(310) 315-8900Fax(310) 315-8902Mailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 301-8707Fax(310) 301-8751Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA159955CaliforniaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseA159955California