Healthcare Provider Details

I. General information

NPI: 1457641102
Provider Name (Legal Business Name): RACHEL I MASON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5864 S DURANGO DR STE 105
LAS VEGAS NV
89113-2276
US

IV. Provider business mailing address

9517 TREASURE BEACH CT
LAS VEGAS NV
89117-3609
US

V. Phone/Fax

Practice location:
  • Phone: 702-359-5462
  • Fax: 725-206-7825
Mailing address:
  • Phone: 702-630-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number30022
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: