Individual ProviderSteven GhaliliFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address648 E 21st St, Los Angeles, CA 90011-1146(213) 749-7110PECOS EnrollmentBased on the most recent information from CMS, provider Steven Ghalili 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 15 days ago.Profile DetailsProvider ID1669546453Provider TypeIndividualFull NameGhalili, StevenTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date11/20/2006Last Updated10/10/2007Contact InformationPractice LocationPractice Address648 E 21st St, Los Angeles, CA 90011-1146Phone(213) 749-7110Fax(213) 749-2749Mailing LocationMailing Address648 E 21st St, Los Angeles, CA 90011-1146Phone(213) 749-7110Fax(213) 749-2749Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseA666150CaliforniaProvider IdentifiersIDDescriptionIssuerID00A666150DescriptionMedicaidIssuerUnlistedCalifornia