MEDICARE: DR. WILLIAM HENRY MASON DPM

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	213EP1101X	Primary Podiatric Medicine Podiatrist	E1999	CA
2	213E00000X	Podiatrist	E-1999	CA

General Provider Information

NPI Number	:	1538111315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM HENRY MASON DPM

Provider Business Mailing Address
First Line	:	1903 FOUNTAINVIEW CIRCLE
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-5709
Country	:	US
Telephone Number	:	707-541-6133
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 FOUNTAINVIEW CIRCLE
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-5709
Country	:	US
Telephone Number	:	707-541-6133
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/24/2011

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