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Basak Julia Kanlilar-Ruiz

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

200 Medical Plaza Suite 365a, Los Angeles, CA 90095-3026

PECOS Enrollment

This provider is enrolled in PECOS as BASAK KANLILAR-RUIZ.

Based on the most recent information from CMS, provider Basak Julia Kanlilar-Ruiz 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
1477066132
Provider Type
Individual
Full Name
Kanlilar-Ruiz, Basak Julia
Title
Ms.
Credential
NURSE PRACTITIONER

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/15/2017
Last Updated
8/29/2022

Contact Information

Practice Location

200 Medical Plaza Suite 365a, Los Angeles, CA 90095-3026

(310) 825-1597

(310) 206-0007

Mailing Location

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

(310) 301-8707

(310) 301-8751

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 656953 California
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95007489 California
Code 363LA2100X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP95007489 California

Basak Julia Kanlilar-Ruiz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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