Healthcare Provider Details

I. General information

NPI: 1184387201
Provider Name (Legal Business Name): MASYN ENRIGHT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MASYN SMITH

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 RIVER DR
FORT BRAGG CA
95437-5403
US

IV. Provider business mailing address

700 RIVER DR
FORT BRAGG CA
95437-5403
US

V. Phone/Fax

Practice location:
  • Phone: 707-961-4631
  • Fax: 707-964-1192
Mailing address:
  • Phone: 707-961-4631
  • Fax: 707-964-1192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A25437
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTL.0010005
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: