Individual ProviderSiddarth PuriPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1520 San Pablo St Ste 1652, Los Angeles, CA 90033-5310(323) 442-5100PECOS EnrollmentBased on the most recent information from CMS, provider Siddarth Puri 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 ID1568718401Provider TypeIndividualFull NamePuri, SiddarthTitleMr.GenderMaleSole ProprietorNoEnumeration Date7/30/2012Last Updated7/30/2021Contact InformationPractice LocationPractice Address1520 San Pablo St Ste 1652, Los Angeles, CA 90033-5310Phone(323) 442-5100FaxUnlisted FaxMailing LocationMailing AddressPO Box 31309, Los Angeles, CA 90031-0309Phone(323) 442-5100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA139447California