Individual ProviderBea KandraAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address3315 Watt Avenue, Case Medical Group, Sacramento, CA 95821-0001(916) 481-0777PECOS EnrollmentBased on the most recent information from CMS, provider Bea Kandra 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 4 days ago.Profile DetailsProvider ID1215076252Provider TypeIndividualFull NameKandra, BeaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date2/6/2007Last Updated12/7/2010Contact InformationPractice LocationPractice Address3315 Watt Avenue, Case Medical Group, Sacramento, CA 95821-0001Phone(916) 481-0777FaxUnlisted FaxMailing LocationMailing Address3315 Watt Ave, Sacramento, CA 95821-3600Phone(916) 481-0777FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense2004-0820New MexicoProvider IdentifiersIDDescriptionIssuerIDZZZ16448ZDescriptionOtherIssuerGROUP PTAN NUMBERCalifornia