MEDICARE: MACIE A FRAME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Q00000X	Pathology Specialist/Technologist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1568226082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACIE A FRAME

Provider Business Mailing Address
First Line	:	1416 S HAYWORTH AVE APT 6
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3953
Country	:	US
Telephone Number	:	484-300-5146
Fax Number	:

Provider Business Practice Location Address
First Line	:	3975 OVERLAND AVE # CA90232
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3722
Country	:	US
Telephone Number	:	310-919-2574
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/14/2024

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Directions to “ MACIE A FRAME ” Practice Location

Language	Start Address	Practice Location

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