Individual ProviderSuphannee LimprathanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Medical Plaza Suite 120, Los Angeles, CA 90095-4197(310) 267-6810(310) 301-8707PECOS EnrollmentBased on the most recent information from CMS, provider Suphannee Limprathan 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 today at 11:47 AM.Profile DetailsProvider ID1487205225Provider TypeIndividualFull NameLimprathan, SuphanneeGenderFemaleSole ProprietorNoEnumeration Date9/23/2019Last Updated11/8/2023Contact InformationPractice LocationPractice Address200 Medical Plaza Suite 120, Los Angeles, CA 90095-4197Phone(310) 267-6810FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 301-8707FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP95011885CaliforniaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95011885California