Individual ProviderJared GoodmanInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822(323) 783-4892PECOS EnrollmentBased on the most recent information from CMS, provider Jared Goodman 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 ID1962760397Provider TypeIndividualFull NameGoodman, JaredCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/23/2012Last Updated12/6/2021Contact InformationPractice LocationPractice Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822Phone(323) 783-4892FaxUnlisted FaxMailing LocationMailing Address4950 W Sunset Blvd Fl 6, Los Angeles, CA 90027-5822PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA119611California