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Mary L Imig

Obstetrics & Gynecology

Allopathic & Osteopathic Physicians

15151 National Ave, Los Gatos, CA 95032-2627

PECOS Enrollment

This provider is enrolled in PECOS as MARY IMIG.

Based on the most recent information from CMS, provider Mary L Imig 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 yesterday at 11:51 AM.

Profile Details

Provider ID
1194780957
Provider Type
Individual
Full Name
Imig, Mary L
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/17/2006
Last Updated
7/1/2010

Contact Information

Practice Location

15151 National Ave, Los Gatos, CA 95032-2627

(408) 356-0431

(408) 358-1602

Mailing Location

15151 National Ave, Los Gatos, CA 95032-2627

(408) 356-0431

(408) 358-1602

Provider Taxonomies

Code	Description	License
Code 207V00000X Primary	Description Obstetrics & Gynecology Allopathic & Osteopathic Physicians	License G61752 California

Mary L Imig

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Lam, Christina

Martinez, Eleanor

Kapur, Natasha

Pollard, Angela

Adie, Elizabeth Marie

Bolanos, Jose Raul

Basham, Elizabeth D

Chen, Ling P

Kim Dang, Md Corporation

Damore, Anthony J