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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 2 days ago.

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

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