MEDICARE: DR. ELLEN AKEMI MACHIKAWA M.D.

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	2084P0800X	Psychiatry Physician	A60726	CA

General Provider Information

NPI Number	:	1902007552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLEN AKEMI MACHIKAWA M.D.

Provider Business Mailing Address
First Line	:	1866 VERDE VISTA DR
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-2219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	573 S BOYLE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-3816
Country	:	US
Telephone Number	:	323-268-3655
Fax Number	:	323-268-8610

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	01/28/2012

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