Individual ProviderMitali WadekarPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address4448 Ambrose Ave, Los Angeles, CA 90027-2115(323) 644-1998PECOS EnrollmentBased on the most recent information from CMS, provider Mitali Wadekar 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 34 days ago.Profile DetailsProvider ID1588853014Provider TypeIndividualFull NameWadekar, MitaliTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date10/22/2007Last Updated3/20/2013Contact InformationPractice LocationPractice Address4448 Ambrose Ave, Los Angeles, CA 90027-2115Phone(323) 644-1998Fax(323) 644-2600Mailing LocationMailing Address4448 Ambrose Ave, Los Angeles, CA 90027-2115Phone(323) 644-1998Fax(323) 644-2600Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA110765California