Individual ProviderAmelework WodajoNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address757 Westwood Plz, Los Angeles, CA 90095-8358(310) 267-8443PECOS EnrollmentBased on the most recent information from CMS, provider Amelework Wodajo 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 11 days ago.Profile DetailsProvider ID1508229568Provider TypeIndividualFull NameWodajo, AmeleworkGenderFemaleSole ProprietorNoEnumeration Date3/29/2016Last Updated3/29/2016Contact InformationPractice LocationPractice Address757 Westwood Plz, Los Angeles, CA 90095-8358Phone(310) 267-8443FaxUnlisted FaxMailing LocationMailing Address10749 Francis Pl Apt 104, Los Angeles, CA 90034-6287PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95003065California