Individual ProviderWilliam BondareffPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1520 San Pablo St, Los Angeles, CA 90033-5310(323) 442-5955PECOS EnrollmentBased on the most recent information from CMS, provider William Bondareff 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 ID1225074156Provider TypeIndividualFull NameBondareff, WilliamCredentialMD,PHDGenderMaleSole ProprietorNoEnumeration Date6/20/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1520 San Pablo St, Los Angeles, CA 90033-5310Phone(323) 442-5955Fax(323) 442-5953Mailing LocationMailing AddressPO Box 31309, Los Angeles, CA 90031-0309Phone(323) 442-5955Fax(326) 442-5953Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseG44324CaliforniaProvider IdentifiersIDDescriptionIssuerID00G443240DescriptionMedicaidIssuerUnlistedCalifornia