Healthcare Provider Details
I. General information
NPI: 1194634287
Provider Name (Legal Business Name): MASON GERARD SALDANA LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
411 N. CENTRAL AVE SUITE 350
GLENDALE CA
91203
US
IV. Provider business mailing address
3010 WILSHIRE BLVD. PMB 435
LOS ANGELES CA
90010
US
V. Phone/Fax
- Phone: 310-421-6503
- Fax:
- Phone: 725-260-7368
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: