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General NPI Number Information
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NPI Number | 1407337439
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Entity Type | Individual
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Provider Name | MASON LANG OD
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Gender | Male
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 30600 DYER ST
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City | UNION CITY
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State | CA
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Zip | 94587-1717
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Country | US
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Telephone | 510-431-3142
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PAWNEE PL
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City | FREMONT
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State | CA
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Zip | 94539-3306
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Country | US
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Telephone | 510-456-5848
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 008867
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34493
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License Number State | CA
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