Individual ProviderKianoush ShakibInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4950 W Sunset Blvd, 6th Floor, Los Angeles, CA 90027-5822(917) 669-7949PECOS EnrollmentBased on the most recent information from CMS, provider Kianoush Shakib does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1649423377Provider TypeIndividualFull NameShakib, KianoushCredentialMDGenderMaleSole ProprietorYesEnumeration Date10/26/2008Last Updated10/26/2008Contact InformationPractice LocationPractice Address4950 W Sunset Blvd, 6th Floor, Los Angeles, CA 90027-5822Phone(917) 669-7949FaxUnlisted FaxMailing LocationMailing Address4950 W Sunset Blvd, 6th Floor, Los Angeles, CA 90027-5822Phone(917) 669-7949FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA105432California