Individual ProviderAisha MemonFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address660 Baker St Ste A101, Costa Mesa, CA 92626-4407(714) 668-2500(657) 241-3600PECOS EnrollmentBased on the most recent information from CMS, provider Aisha Memon 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 2 days ago.Profile DetailsProvider ID1740620046Provider TypeIndividualFull NameMemon, AishaTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date7/1/2013Last Updated7/21/2023Contact InformationPractice LocationPractice Address660 Baker St Ste A101, Costa Mesa, CA 92626-4407Phone(714) 668-2500Fax(714) 668-2515Mailing LocationMailing AddressPO Box 2218, Suisun City, CA 94585-5218Phone(657) 241-3600Fax(657) 241-7708Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseA139079CaliforniaCode207QG0300XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseA139079CaliforniaProvider IdentifiersIDDescriptionIssuerIDCB281977DescriptionOtherIssuerMEDICARECalifornia