Individual ProviderElizabeth VandenbogaartNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice AddressUcla 100 Medical Plz, Suite 630e, Los Angeles, CA 90095-7368(310) 825-8816PECOS EnrollmentBased on the most recent information from CMS, provider Elizabeth Vandenbogaart 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 ID1710228093Provider TypeIndividualFull NameVandenbogaart, ElizabethTitleMs.CredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date3/11/2013Last Updated3/11/2013Contact InformationPractice LocationPractice AddressUcla 100 Medical Plz, Suite 630e, Los Angeles, CA 90095-7368Phone(310) 825-8816Fax(310) 825-9013Mailing LocationMailing AddressUcla 100 Medical Plz, Suite 630e, Los Angeles, CA 90095-7368Phone(310) 825-8816Fax(310) 825-9013Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense20087California