Individual ProviderAnnie HanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address463 N Magnolia Ave, El Cajon, CA 92020-3606(629) 522-0399PECOS EnrollmentBased on the most recent information from CMS, provider Annie Han 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 yesterday at 12:57 PM.Profile DetailsProvider ID1376085290Provider TypeIndividualFull NameHan, AnnieGenderFemaleSole ProprietorNoEnumeration Date11/9/2016Last Updated11/9/2016Contact InformationPractice LocationPractice Address463 N Magnolia Ave, El Cajon, CA 92020-3606Phone(629) 522-0399FaxUnlisted FaxMailing LocationMailing Address463 N Magnolia Ave, El Cajon, CA 92020-3606Phone(629) 522-0399FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95005370CaliforniaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense792169California