Look up the most recent NPI and PECOS records

Leonora B Bantugan

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

200 Ucla Medical Plz Ste 565c, Los Angeles, CA 90095-1252

PECOS Enrollment

This provider is enrolled in PECOS as LEONORA BANTUGAN.

Based on the most recent information from CMS, provider Leonora B Bantugan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1285393181
Provider Type
Individual
Full Name
Bantugan, Leonora B
Gender
Female

Sole Proprietor
Yes
Enumeration Date
12/8/2021
Last Updated
8/1/2024

Contact Information

Practice Location

200 Ucla Medical Plz Ste 565c, Los Angeles, CA 90095-1252

(310) 267-2555

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

(310) 301-8707

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95019337 California
Code 363LP2300X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95019337 California

Leonora B Bantugan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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