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Marion Eleanor Mcrae

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

757 Westwood Plz, Los Angeles, CA 90095-8358

PECOS Enrollment

This provider is enrolled in PECOS as MARION MCRAE.

Based on the most recent information from CMS, provider Marion Eleanor Mcrae is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 11 days ago.

Profile Details

Provider ID
1063675957
Provider Type
Individual
Full Name
Mcrae, Marion Eleanor
Title
Ms.
Credential
RN, NP

Gender
Female
Sole Proprietor
No
Enumeration Date
7/9/2008
Last Updated
7/21/2022

Contact Information

Practice Location

757 Westwood Plz, Los Angeles, CA 90095-8358

(310) 267-7765

Unlisted Fax

Mailing Location

118 South Clark Drive, #102, West Hollywood, CA 90048

(310) 994-1780

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP15934 California
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License RN457714 California

Provider Identifiers

ID	Description	Issuer
ID 1063675957	Description Medicaid	Issuer Unlisted California

Marion Eleanor Mcrae

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Bau, Sherona N

Gewarges, Renee Mary

Chavarria, Allison Yumiko

Lau, Stephanie Wei Wen

Adkins, Danica Helen Whisman

Wheatley, Tia

Ong, Joe Andrews

Orloff, Tatiana N

So, Eileen Linda

Vu, Jennifer