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Amanda Spicer Mazza

Internal Medicine

Allopathic & Osteopathic Physicians

4950 W Sunset Blvd # 6b, Los Angeles, CA 90027-5822

PECOS Enrollment

This provider is enrolled in PECOS as AMANDA MAZZA.

Based on the most recent information from CMS, provider Amanda Spicer Mazza 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 2 days ago.

Profile Details

Provider ID
1396998753
Provider Type
Individual
Full Name
Mazza, Amanda Spicer
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/29/2008
Last Updated
12/1/2021

Contact Information

Practice Location

4950 W Sunset Blvd # 6b, Los Angeles, CA 90027-5822

(800) 954-8000

Unlisted Fax

Mailing Location

4950 W Sunset Blvd # 6b, Los Angeles, CA 90027-5822

(800) 954-8000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A105909 California

Amanda Spicer Mazza

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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