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General NPI Number Information
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NPI Number | 1619000445
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Entity Type | Organization
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Legal Business Name | GORDON DAVID MASON
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3579 ARLINGTON AVE SUITE 400
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City | RIVERSIDE
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State | CA
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Zip | 92506-3915
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Country | US
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Telephone | 951-788-7778
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Fax | 951-682-4188
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Provider Business Mailing Address
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Address Line | 3579 ARLINGTON AVE SUITE 400
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City | RIVERSIDE
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State | CA
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Zip | 92506-3915
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Country | US
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Telephone | 951-788-7778
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Fax | 951-682-4188
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Authorized Official
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Title or Position | OWNER
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Name | GORDON MASON
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Credential |
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Telephone | 951-788-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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