Individual ProviderRasham MittalInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1526 N Edgemont St Fl 7, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027-5260(347) 822-8987(800) 954-8000PECOS EnrollmentBased on the most recent information from CMS, provider Rasham Mittal 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 2 days ago.Profile DetailsProvider ID1538502992Provider TypeIndividualFull NameMittal, RashamCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date4/16/2013Last Updated11/22/2021Contact InformationPractice LocationPractice Address1526 N Edgemont St Fl 7, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027-5260Phone(347) 822-8987FaxUnlisted FaxMailing LocationMailing Address1526 N Edgemont St Fl 7, Los Angeles, CA 90027-5260Phone(800) 954-8000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA119893California