Individual ProviderParntip ChertboonmuangNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10833 Le Conte Ave, Los Angeles, CA 90095-3075(310) 825-9820(310) 384-7527PECOS EnrollmentBased on the most recent information from CMS, provider Parntip Chertboonmuang 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 12:00 PM.Profile DetailsProvider ID1487078002Provider TypeIndividualFull NameChertboonmuang, ParntipCredentialAG-ACNPGenderFemaleSole ProprietorNoEnumeration Date2/18/2014Last Updated3/17/2018Contact InformationPractice LocationPractice Address10833 Le Conte Ave, Los Angeles, CA 90095-3075Phone(310) 825-9820FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 384-7527FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95000122California