OrganizationEvolution Holistic Medical Group - Los Angeles, Inc.(<Unavail>)Orthopaedic SurgeryAllopathic & Osteopathic PhysiciansPractice Address8670 Wilshire Blvd, Suite 204, Beverly Hills, CA 90211-2924(800) 821-5422(818) 402-8898PECOS EnrollmentBased on the most recent information from CMS, provider Evolution Holistic Medical Group - Los Angeles, 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 2 days ago.Profile DetailsProvider ID1447641824Provider TypeOrganizationFull NameEvolution Holistic Medical Group - Los Angeles, Inc.Other Name<Unavail>SubpartNoEnumeration Date2/6/2015Last Updated2/6/2015Contact InformationPractice LocationPractice Address8670 Wilshire Blvd, Suite 204, Beverly Hills, CA 90211-2924Phone(800) 821-5422FaxUnlisted FaxMailing LocationMailing Address269 S Beverly Dr, 110, Beverly Hills, CA 90212-3851Phone(818) 402-8898FaxUnlisted FaxAuthorized OfficialNameBullock, Aaron V (Vice Secretary)Phone(818) 402-8898Provider TaxonomiesCodeDescriptionLicenseCode207X00000XPrimaryDescriptionOrthopaedic SurgeryAllopathic & Osteopathic PhysiciansLicenseA72861CaliforniaCode111N00000XDescriptionChiropractorChiropractic ProvidersLicenseUnlisted IssuerCode171100000XDescriptionAcupuncturistOther Service ProvidersLicenseAC10770CaliforniaCode208D00000XDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseA72861CaliforniaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT36165California