Individual ProviderJeanney KangInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1250 16th St # C2304, Santa Monica, CA 90404-1249(310) 825-9111PECOS EnrollmentBased on the most recent information from CMS, provider Jeanney Kang 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 6 days ago.Profile DetailsProvider ID1285130237Provider TypeIndividualFull NameKang, JeanneyGenderFemaleSole ProprietorNoEnumeration Date3/30/2018Last Updated5/26/2021Contact InformationPractice LocationPractice Address1250 16th St # C2304, Santa Monica, CA 90404-1249Phone(310) 825-9111FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA164809CaliforniaCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseA164809California