Individual ProviderBryant BaldoradoNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address757 Westwood Plz, Los Angeles, CA 90095-4672(310) 825-9111PECOS EnrollmentBased on the most recent information from CMS, provider Bryant Baldorado 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 11 days ago.Profile DetailsProvider ID1639717044Provider TypeIndividualFull NameBaldorado, BryantGenderMaleSole ProprietorYesEnumeration Date12/16/2019Last Updated2/8/2022Contact InformationPractice LocationPractice Address757 Westwood Plz, Los Angeles, CA 90095-4672Phone(310) 825-9111FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95013135California