Individual ProviderRoshanak EftekhariInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1300 N Vermont Ave, Suite# 807, Los Angeles, CA 90027-6005(323) 660-5191PECOS EnrollmentBased on the most recent information from CMS, provider Roshanak Eftekhari 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 ID1619936556Provider TypeIndividualFull NameEftekhari, RoshanakTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date3/20/2006Last Updated3/17/2016Contact InformationPractice LocationPractice Address1300 N Vermont Ave, Suite# 807, Los Angeles, CA 90027-6005Phone(323) 660-5191Fax(323) 660-6513Mailing LocationMailing Address1300 N Vermont Ave, Suite# 807, Los Angeles, CA 90027-6005Phone(323) 660-5191Fax(323) 660-6513Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA76119CaliforniaProvider IdentifiersIDDescriptionIssuerID1619936556DescriptionOtherIssuerNPIIDWA76119ADescriptionMedicaidIssuerUnlistedCalifornia