Individual ProviderSassan DavoudiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1300 N Vermont Ave, Los Angeles, CA 90027-6005(323) 913-4592(818) 345-6655PECOS EnrollmentBased on the most recent information from CMS, provider Sassan Davoudi 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 2 days ago.Profile DetailsProvider ID1821215302Provider TypeIndividualFull NameDavoudi, SassanCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/19/2007Last Updated3/29/2010Contact InformationPractice LocationPractice Address1300 N Vermont Ave, Los Angeles, CA 90027-6005Phone(323) 913-4592FaxUnlisted FaxMailing LocationMailing Address5071 Garden Grove Ave, Tarzana, CA 91356-4317Phone(818) 345-6655FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA90942California