Individual ProviderGeraldine PavezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address100 Ucla Medical Plaza, Suite 660, Los Angeles, CA 90095(310) 206-2235PECOS EnrollmentBased on the most recent information from CMS, provider Geraldine Pavez 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 ID1710290226Provider TypeIndividualFull NamePavez, GeraldineCredentialACNPGenderFemaleSole ProprietorNoEnumeration Date7/26/2010Last Updated2/27/2012Contact InformationPractice LocationPractice Address100 Ucla Medical Plaza, Suite 660, Los Angeles, CA 90095Phone(310) 206-2235Fax(310) 825-2092Mailing LocationMailing Address100 Ucla Medical Plaza, Suite 660, Los Angeles, CA 90095Phone(310) 206-2235Fax(310) 825-2092Provider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP19294California