Individual ProviderIan LopezStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3800 W Chapman Ave Ste 3200, Orange, CA 92868-1638(714) 456-5239PECOS EnrollmentBased on the most recent information from CMS, provider Ian Lopez 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 9:43 AM.Profile DetailsProvider ID1639864440Provider TypeIndividualFull NameLopez, IanGenderMaleSole ProprietorNoEnumeration Date4/7/2023Last Updated4/7/2023Contact InformationPractice LocationPractice Address3800 W Chapman Ave Ste 3200, Orange, CA 92868-1638Phone(714) 456-5239FaxUnlisted FaxMailing LocationMailing Address3800 W Chapman Ave Ste 3200, Orange, CA 92868-1638Phone(714) 456-5239FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer