Individual ProviderMichael Irvin RudinMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address1328 Westwood Blvd, Suite 8, Los Angeles, CA 90024-4941(310) 259-5606PECOS EnrollmentBased on the most recent information from CMS, provider Michael Irvin Rudin 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 2 days ago.Profile DetailsProvider ID1043671662Provider TypeIndividualFull NameRudin, Michael IrvinTitleMr.GenderMaleSole ProprietorYesEnumeration Date3/9/2016Last Updated3/9/2016Contact InformationPractice LocationPractice Address1328 Westwood Blvd, Suite 8, Los Angeles, CA 90024-4941Phone(310) 259-5606FaxUnlisted FaxMailing LocationMailing Address1328 Westwood Blvd, Suite 8, Los Angeles, CA 90024-4941Phone(310) 259-5606FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC 53187California