Individual ProviderRoseller Martin DitangcoInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4800 Alberta Ave, El Paso, TX 79905-2709(915) 215-8000(818) 621-5036PECOS EnrollmentBased on the most recent information from CMS, provider Roseller Martin Ditangco 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 2 days ago.Profile DetailsProvider ID1558852665Provider TypeIndividualFull NameDitangco, Roseller MartinGenderMaleSole ProprietorNoEnumeration Date5/24/2018Last Updated7/29/2022Contact InformationPractice LocationPractice Address4800 Alberta Ave, El Paso, TX 79905-2709Phone(915) 215-8000FaxUnlisted FaxMailing LocationMailing Address4800 Alberta Ave, El Paso, TX 79905-2709Phone(818) 621-5036FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA173531California