Individual ProviderPreethi PrasadInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1250 16th St, Suite A454, Santa Monica, CA 90404-1249(310) 319-4698PECOS EnrollmentBased on the most recent information from CMS, provider Preethi Prasad 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 6 days ago.Profile DetailsProvider ID1457612483Provider TypeIndividualFull NamePrasad, PreethiCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/6/2012Last Updated12/3/2021Contact InformationPractice LocationPractice Address1250 16th St, Suite A454, Santa Monica, CA 90404-1249Phone(310) 319-4698FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd, Suite 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA137478CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer