OrganizationWestside Primary Care, Inc.Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address2428 Santa Monica Blvd Ste 402, Santa Monica, CA 90404-2047(310) 449-4595(310) 829-3385PECOS EnrollmentBased on the most recent information from CMS, provider Westside Primary Care, Inc. 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 6 days ago.Profile DetailsProvider ID1760567200Provider TypeOrganizationFull NameWestside Primary Care, Inc.SubpartNoEnumeration Date10/25/2006Last Updated9/22/2014Contact InformationPractice LocationPractice Address2428 Santa Monica Blvd Ste 402, Santa Monica, CA 90404-2047Phone(310) 449-4595Fax(310) 828-6635Mailing LocationMailing Address9613 Kirkside Rd, Los Angeles, CA 90035-4009Phone(310) 829-3385Fax(310) 828-6635Authorized OfficialNameHaider, Romana (President)Phone(310) 829-3385Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA78716