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General NPI Number Information
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NPI Number | 1598854531
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Entity Type | Individual
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Provider Name | JOHN MASSOUD ATC, LMP, NCTM
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 22471 ASPAN ST SUITE 110
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City | LAKE FOREST
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State | CA
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Zip | 92630-1642
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Country | US
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Telephone | 949-583-1797
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Fax | 949-586-5701
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Provider Business Mailing Address
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Address Line | 5 HIDDEN CREEK LN
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4479
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 500748-05
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | CA
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