Individual ProviderJessica LiaoInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1245 16th St Ste 309, Santa Monica, CA 90404-1239(310) 319-4262(310) 206-4083PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Liao 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 5 days ago.Profile DetailsProvider ID1851528442Provider TypeIndividualFull NameLiao, JessicaTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date6/22/2009Last Updated4/17/2018Contact InformationPractice LocationPractice Address1245 16th St Ste 309, Santa Monica, CA 90404-1239Phone(310) 319-4262FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631Phone(310) 206-4083FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA114066California