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NPI Code Detail

MEDICARE: MATTHEW AARON FREY RPT

MEDICARE:   MATTHEW AARON FREY  RPT
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
1225100000XPhysical TherapistPT25310CA

General Provider Information

NPI Number : 1467642702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW AARON FREY RPT
Provider Business Mailing Address
First Line : 3966 MARCASEL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-4616
Country : US
Telephone Number : 310-397-2372
Fax Number : 310-915-2086
Provider Business Practice Location Address
First Line : 3966 MARCASEL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-4616
Country : US
Telephone Number : 310-397-2372
Fax Number : 310-915-2086
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 08/01/2007

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Directions to “ MATTHEW AARON FREY RPT” Practice Location

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