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General NPI Number Information
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NPI Number | 1457447112
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Entity Type | Organization
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Legal Business Name | SANJAY MASSON MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 SOUTH AKERS ST
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City | VISALIA
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State | CA
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Zip | 93277
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Country | US
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Telephone | 559-624-3323
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Fax |
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Provider Business Mailing Address
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Address Line | P.O.BOX 6998
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City | VISALIA
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State | CA
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Zip | 93290
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Country | US
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Telephone | 559-624-3323
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Fax | 559-734-7713
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANJAY MASSON
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Credential | MD
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Telephone | 559-624-3323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A90258
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License Number State | CA
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