Individual ProviderPriscilla MoonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address5926 Monterey Rd, Los Angeles, CA 90042-4943(323) 503-1414(626) 264-0714PECOS EnrollmentBased on the most recent information from CMS, provider Priscilla Moon 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 ID1518641232Provider TypeIndividualFull NameMoon, PriscillaGenderFemaleSole ProprietorYesEnumeration Date6/13/2023Last Updated6/13/2023Contact InformationPractice LocationPractice Address5926 Monterey Rd, Los Angeles, CA 90042-4943Phone(323) 503-1414FaxUnlisted FaxMailing LocationMailing Address200 Monte Vista Ln, Sierra Madre, CA 91024-2609Phone(626) 264-0714FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense304127California