Look up the most recent NPI and PECOS records

Kevin Larry Garcia Mariano

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

757 Westwood Plz, Los Angeles, CA 90095-8358

PECOS Enrollment

This provider is enrolled in PECOS as KEVIN LARRY MARIANO.

Based on the most recent information from CMS, provider Kevin Larry Garcia Mariano 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 10 days ago.

Profile Details

Provider ID
1639638570
Provider Type
Individual
Full Name
Mariano, Kevin Larry Garcia
Title
Mr.
Credential
DNP

Gender
Male
Sole Proprietor
No
Enumeration Date
3/19/2019
Last Updated
1/5/2021

Contact Information

Practice Location

757 Westwood Plz, Los Angeles, CA 90095-8358

(323) 346-4587

Unlisted Fax

Mailing Location

757 Westwood Plz, Los Angeles, CA 90095-8358

(323) 346-4587

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95011435 California

Kevin Larry Garcia Mariano

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Mcrae, Marion Eleanor

Lee, David

Quinn, Christine Marie

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Patricio, Jordan Augustine

Wu, Nathaly

Lipsky, Charlotte

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Chung, Michelle K