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Cynthia A. Purviance

Emergency Medicine

Allopathic & Osteopathic Physicians

8910 Villa La Jolla Dr, La Jolla, CA 92037

PECOS Enrollment

This provider is enrolled in PECOS as CYNTHIA PURVIANCE.

Based on the most recent information from CMS, provider Cynthia A. Purviance 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 8:18 PM.

Profile Details

Provider ID
1851370555
Provider Type
Individual
Full Name
Purviance, Cynthia A.
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
1/11/2006
Last Updated
10/4/2018

Contact Information

Practice Location

8910 Villa La Jolla Dr, La Jolla, CA 92037

(858) 249-6800

(858) 539-8781

Mailing Location

PO Box 232410, San Diego, CA 92193-2410

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License A61273 California

Provider Identifiers

ID	Description	Issuer
ID 00A612730	Description Medicaid	Issuer Unlisted California

Cynthia A. Purviance

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Olcott, Mark Vernon

Letai, Agnes D.

Bianchi Medical Services Pc

Obler, Richard M

Demott, Megan C

Guluma, Kama Z

Scripps Health

Reilly, Ian

Baehr, George R

Wiesner, Christopher T