Tara Leanne Sedlak | Los Angeles, CA • PECOS Search

Tara Leanne Sedlak

Internal Medicine

Allopathic & Osteopathic Physicians

444 S San Vicente Blvd Ste 600, Los Angeles, CA 90048-4174

(310) 423-9979 (310) 691-9563

PECOS Enrollment

Based on the most recent information from CMS, provider Tara Leanne Sedlak does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1508154188
Provider Type
Individual
Full Name
Sedlak, Tara Leanne
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/15/2011
Last Updated
7/15/2011

Contact Information

Practice Location

444 S San Vicente Blvd Ste 600, Los Angeles, CA 90048-4174

Unlisted Fax

Mailing Location

5700 W 6th St Apt 422, Los Angeles, CA 90036-5820

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RC0000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A117536 California