Look up the most recent NPI and PECOS records

Bo Marcus Gustafsson

Emergency Medicine

Allopathic & Osteopathic Physicians

4445 Magnolia Ave, Riverside Community Hospital Gme Office, Riverside, CA 92501-4135

PECOS Enrollment

This provider is enrolled in PECOS as BO GUSTAFSSON.

Based on the most recent information from CMS, provider Bo Marcus Gustafsson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1801321682
Provider Type
Individual
Full Name
Gustafsson, Bo Marcus
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/28/2017
Last Updated
11/29/2021

Contact Information

Practice Location

4445 Magnolia Ave, Riverside Community Hospital Gme Office, Riverside, CA 92501-4135

(951) 788-3000

Unlisted Fax

Mailing Location

4445 Magnolia Ave, Riverside Community Hospital Gme Office, Riverside, CA 92501-4135

(951) 788-3000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 21577 Nevada

Bo Marcus Gustafsson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Woodhouse, Ernest

Cep America - California

Lau, Nicole Wai-Ga

Guth, Richard Harland

Ghassemzadeh, Sassan

Kang, Michael

Dale, Kenneth M

Johnson, Kenneth

Fukuda, Matthew David

Louthan, Michael James Elder