Individual ProviderEric WagreichPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1200 N State St, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029(323) 409-5555PECOS EnrollmentBased on the most recent information from CMS, provider Eric Wagreich 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 ID1205367232Provider TypeIndividualFull NameWagreich, EricTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/22/2017Last Updated9/15/2020Contact InformationPractice LocationPractice Address1200 N State St, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029Phone(323) 409-5555FaxUnlisted FaxMailing LocationMailing Address2010 Zonal Ave # 1p10, Los Angeles, CA 90033-1026PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA161162CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer