OrganizationDornika Medical, Inc.Family MedicineAllopathic & Osteopathic PhysiciansPractice Address2121 S San Pedro St, Unit E, Los Angeles, CA 90011-1160(213) 747-0300PECOS EnrollmentBased on the most recent information from CMS, provider Dornika Medical, Inc. 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 15 days ago.Profile DetailsProvider ID1417365545Provider TypeOrganizationFull NameDornika Medical, Inc.SubpartNoEnumeration Date8/1/2014Last Updated8/1/2014Contact InformationPractice LocationPractice Address2121 S San Pedro St, Unit E, Los Angeles, CA 90011-1160Phone(213) 747-0300Fax(213) 746-0044Mailing LocationMailing Address125 Oasis, Irvine, CA 92620-7315Phone(213) 747-0300Fax(213) 746-0044Authorized OfficialNameMotamedi, Bijan (Part Owner)Phone(213) 747-0300Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseA76326CaliforniaProvider IdentifiersIDDescriptionIssuerIDA76326DescriptionOtherIssuerPROVIDER LISCENSECalifornia