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Elizabeth Ann Nieto

Internal Medicine

Allopathic & Osteopathic Physicians

26800 Crown Valley Pkwy Ste 325, Mission Viejo, CA 92691-6384

PECOS Enrollment

This provider is enrolled in PECOS as ELIZABETH NIETO.

Based on the most recent information from CMS, provider Elizabeth Ann Nieto is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1689020760
Provider Type
Individual
Full Name
Nieto, Elizabeth Ann
Credential
M.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/9/2016
Last Updated
10/28/2020

Contact Information

Practice Location

26800 Crown Valley Pkwy Ste 325, Mission Viejo, CA 92691-6384

(949) 364-6000

Unlisted Fax

Mailing Location

26800 Crown Valley Pkwy Ste 325, Mission Viejo, CA 92691-6384

(949) 364-6000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A168450 California

Elizabeth Ann Nieto

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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