Individual ProviderPrediman ShahInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address8700 Beverly Blvd, Los Angeles, CA 90048-1865(310) 423-3844(310) 423-3884PECOS EnrollmentBased on the most recent information from CMS, provider Prediman Shah 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 4 days ago.Profile DetailsProvider ID1447394036Provider TypeIndividualFull NameShah, PredimanTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date2/16/2007Last Updated2/9/2018Contact InformationPractice LocationPractice Address8700 Beverly Blvd, Los Angeles, CA 90048-1865Phone(310) 423-3844Fax(310) 423-0144Mailing LocationMailing AddressPO Box 512717, Los Angeles, CA 90051-0717Phone(310) 423-3884Fax(310) 423-0144Provider TaxonomiesCodeDescriptionLicenseCode207RC0000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA31604CaliforniaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA31604California