Individual ProviderBahar MadaniInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address10666 N Torrey Pines Rd, La Jolla, CA 92037-1027(858) 554-4310(858) 784-5888PECOS EnrollmentBased on the most recent information from CMS, provider Bahar Madani 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 yesterday at 12:57 PM.Profile DetailsProvider ID1730356106Provider TypeIndividualFull NameMadani, BaharTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date5/14/2008Last Updated10/5/2020Contact InformationPractice LocationPractice Address10666 N Torrey Pines Rd, La Jolla, CA 92037-1027Phone(858) 554-4310FaxUnlisted FaxMailing LocationMailing Address10170 Sorrento Valley Rd, Pavillion Iii, Suite #268, San Diego, CA 92121-1604Phone(858) 784-5888FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RG0100XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense101882CaliforniaCode207RI0008XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseN5211TexasCode174400000XDescriptionSpecialistOther Service ProvidersLicense101882CaliforniaProvider IdentifiersIDDescriptionIssuerID8CH059DescriptionOtherIssuerBLUE CROSSTexas