Individual ProviderGary Duane NelsonPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1 Medical Plaza Dr, Roseville, CA 95661-3037(916) 781-1000(510) 350-2600PECOS EnrollmentBased on the most recent information from CMS, provider Gary Duane Nelson 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 5 days ago.Profile DetailsProvider ID1467474908Provider TypeIndividualFull NameNelson, Gary DuaneCredentialP.A-CGenderMaleSole ProprietorNoEnumeration Date7/24/2006Last Updated10/26/2007Contact InformationPractice LocationPractice Address1 Medical Plaza Dr, Roseville, CA 95661-3037Phone(916) 781-1000FaxUnlisted FaxMailing LocationMailing Address2100 Powell St, Ste 900, Emeryville, CA 94608-1826Phone(510) 350-2600Fax(510) 879-9100Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA11919California