Healthcare Provider Details

I. General information

NPI: 1740889039
Provider Name (Legal Business Name): NATALIE MASADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 N INDIAN HILL BLVD
CLAREMONT CA
91711-4609
US

IV. Provider business mailing address

224 N INDIAN HILL BLVD
CLAREMONT CA
91711-4609
US

V. Phone/Fax

Practice location:
  • Phone: 909-621-0447
  • Fax:
Mailing address:
  • Phone: 909-621-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number298980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: