OrganizationSvetlana G. Segal M.D.,Ph.D.,CorporationInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address6221 Wilshire Blvd, #210, Los Angeles, CA 90048-5201(323) 651-3228PECOS EnrollmentBased on the most recent information from CMS, provider Svetlana G. Segal M.D.,Ph.D.,Corporation 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 4 days ago.Profile DetailsProvider ID1821110891Provider TypeOrganizationFull NameSvetlana G. Segal M.D.,Ph.D.,CorporationSubpartNoEnumeration Date4/3/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address6221 Wilshire Blvd, #210, Los Angeles, CA 90048-5201Phone(323) 651-3228Fax(323) 651-0280Mailing LocationMailing Address6221 Wilshire Blvd, #210, Los Angeles, CA 90048-5201Phone(323) 651-3228Fax(323) 651-0280Authorized OfficialNameSegal, Svetlana (Owner,Provider,President)Phone(323) 651-3228Provider TaxonomiesCodeDescriptionLicenseCode207RC0000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA38892CaliforniaProvider IdentifiersIDDescriptionIssuerIDGR0057100DescriptionMedicaidIssuerUnlistedCalifornia