Healthcare Provider Details

I. General information

NPI: 1730099599
Provider Name (Legal Business Name): MASSARA ABBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24167 PASEO DE VALENCIA
LAGUNA WOODS CA
92637-3110
US

IV. Provider business mailing address

24167 PASEO DE VALENCIA
LAGUNA WOODS CA
92637-3110
US

V. Phone/Fax

Practice location:
  • Phone: 949-586-3503
  • Fax: 949-586-2111
Mailing address:
  • Phone: 949-586-3503
  • Fax: 949-586-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: