Individual ProviderLupita Diaz-NavarroNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Ucla Medical Plz Ste 530, Los Angeles, CA 90095-2613(310) 825-7922PECOS EnrollmentBased on the most recent information from CMS, provider Lupita Diaz-Navarro 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 11 days ago.Profile DetailsProvider ID1245773670Provider TypeIndividualFull NameDiaz-Navarro, LupitaTitleMissCredentialNPGenderFemaleSole ProprietorYesEnumeration Date12/3/2016Last Updated8/9/2019Contact InformationPractice LocationPractice Address200 Ucla Medical Plz Ste 530, Los Angeles, CA 90095-2613Phone(310) 825-7922Fax(310) 267-1899Mailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95004602CaliforniaCode364SA2100XDescriptionClinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing ProvidersLicense4498California