Individual ProviderRafael Lopez ChicasNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Medical Plaza Suite B265, Los Angeles, CA 90095-0001(818) 581-5550PECOS EnrollmentBased on the most recent information from CMS, provider Rafael Lopez Chicas 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 ID1508715426Provider TypeIndividualFull NameLopez Chicas, RafaelGenderMaleSole ProprietorNoEnumeration Date1/23/2026Last Updated1/23/2026Contact InformationPractice LocationPractice Address200 Medical Plaza Suite B265, Los Angeles, CA 90095-0001Phone(818) 581-5550Fax(818) 581-5550Mailing LocationMailing Address22027 Gresham St, West Hills, CA 91304-1322Phone(818) 581-5550Fax(818) 581-5550Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95038297California