Individual ProviderShaian MoradiPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1600 Eureka Rd, Roseville, CA 95661-3027(916) 784-5367PECOS EnrollmentBased on the most recent information from CMS, provider Shaian Moradi is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1528117793Provider TypeIndividualFull NameMoradi, ShaianCredentialPAGenderFemaleSole ProprietorNoEnumeration Date1/9/2007Last Updated6/11/2014Contact InformationPractice LocationPractice Address1600 Eureka Rd, Roseville, CA 95661-3027Phone(916) 784-5367FaxUnlisted FaxMailing LocationMailing Address1600 Eureka Rd, Roseville, CA 95661-3027PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA18761CaliforniaProvider IdentifiersIDDescriptionIssuerIDPA18761DescriptionOtherIssuerPA LICENSE #California