Individual ProviderMarina ShukmanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 Ucla Medical Plz Ste 365b, Los Angeles, CA 90095-8344(310) 825-8061(310) 301-8707PECOS EnrollmentBased on the most recent information from CMS, provider Marina Shukman 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 3 days ago.Profile DetailsProvider ID1891540829Provider TypeIndividualFull NameShukman, MarinaCredentialNPGenderFemaleSole ProprietorYesEnumeration Date4/22/2024Last Updated1/30/2026Contact InformationPractice LocationPractice Address200 Ucla Medical Plz Ste 365b, Los Angeles, CA 90095-8344Phone(310) 825-8061FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd, Ste 400, Los Angeles, CA 90095-5631Phone(310) 301-8707FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95029168CaliforniaCode207RP1001XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense95029168California