Individual ProviderJohn Ellsworth OsborneEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135(909) 788-3000(510) 350-2600PECOS EnrollmentBased on the most recent information from CMS, provider John Ellsworth Osborne does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1912013194Provider TypeIndividualFull NameOsborne, John EllsworthCredentialM.DGenderMaleSole ProprietorNoEnumeration Date8/21/2006Last Updated7/18/2008Contact InformationPractice LocationPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135Phone(909) 788-3000FaxUnlisted FaxMailing LocationMailing Address2100 Powell St, Ste 900, Emeryville, CA 94608-1826Phone(510) 350-2600Fax(510) 879-9100Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseG42163CaliforniaProvider IdentifiersIDDescriptionIssuerID00G421630DescriptionMedicaidIssuerUnlistedCalifornia