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General NPI Number Information
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NPI Number | 1295202083
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Entity Type | Individual
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Provider Name | MASON MATTHEW MCDOWELL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/30/2018
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Last Update Date | 10/30/2018
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Provider Practice Location Address
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Address Line | 1670 GARNET AVE
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City | SAN DIEGO
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State | CA
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Zip | 92109-3116
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Country | US
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Telephone | 858-270-1163
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Fax | 858-270-1178
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Provider Business Mailing Address
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Address Line | 5681 DESERT VIEW DR
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City | LA JOLLA
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State | CA
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Zip | 92037-7239
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Country | US
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Telephone | 509-929-0989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 79887
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License Number State | CA
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