OrganizationEvolution Holistic Medical Group - Los Angeles, Inc.(Evolution Holistic Healthcare)Orthopaedic SurgeryAllopathic & Osteopathic PhysiciansPractice Address8670 Wilshire Blvd, Suite 204, Beverly Hills, CA 90211-2924(800) 821-5422(818) 402-8898PECOS EnrollmentBased on the most recent information from CMS, provider Evolution Holistic Medical Group - Los Angeles, 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 yesterday at 2:25 PM.Profile DetailsProvider ID1447641824Provider TypeOrganizationFull NameEvolution Holistic Medical Group - Los Angeles, Inc.Other NameEvolution Holistic HealthcareSubpartNoEnumeration Date2/6/2015Last Updated2/6/2015Contact InformationPractice LocationPractice Address8670 Wilshire Blvd, Suite 204, Beverly Hills, CA 90211-2924Phone(800) 821-5422FaxUnlisted FaxMailing LocationMailing Address269 S Beverly Dr, 110, Beverly Hills, CA 90212-3851Phone(818) 402-8898FaxUnlisted FaxAuthorized OfficialNameBullock, Aaron V (Vice Secretary)Phone(818) 402-8898Provider TaxonomiesCodeDescriptionLicenseCode207X00000XPrimaryDescriptionOrthopaedic SurgeryAllopathic & Osteopathic PhysiciansLicenseA72861CaliforniaCode111N00000XDescriptionChiropractorChiropractic ProvidersLicenseUnlisted IssuerCode171100000XDescriptionAcupuncturistOther Service ProvidersLicenseAC10770CaliforniaCode208D00000XDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseA72861CaliforniaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT36165California