Individual ProviderMicah MarPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2622 W Madison Cir, Anaheim, CA 92801-4954(650) 201-5104PECOS EnrollmentBased on the most recent information from CMS, provider Micah Mar does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1447034277Provider TypeIndividualFull NameMar, MicahGenderMaleSole ProprietorNoEnumeration Date8/22/2023Last Updated8/22/2023Contact InformationPractice LocationPractice Address2622 W Madison Cir, Anaheim, CA 92801-4954Phone(650) 201-5104FaxUnlisted FaxMailing LocationMailing Address2622 W Madison Cir, Anaheim, CA 92801-4954PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense304489California