Individual ProviderDaljit MacPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address5014 Chesebro Rd., 2nd Floor, Agoura Hills, CA 91301-4232(818) 706-9300PECOS EnrollmentBased on the most recent information from CMS, provider Daljit Mac 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 3 days ago.Profile DetailsProvider ID1871500363Provider TypeIndividualFull NameMac, DaljitCredentialM.D.GenderMaleSole ProprietorYesEnumeration Date8/1/2006Last Updated1/9/2008Contact InformationPractice LocationPractice Address5014 Chesebro Rd., 2nd Floor, Agoura Hills, CA 91301-4232Phone(818) 706-9300Fax(818) 707-2672Mailing LocationMailing Address5014 Chesebro Rd., 2nd Floor, Agoura Hills, CA 91301-4232Phone(818) 706-9300Fax(818) 707-2672Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseC50502CaliforniaProvider IdentifiersIDDescriptionIssuerID00C505020DescriptionMedicaidIssuerUnlistedCalifornia