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General NPI Number Information
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NPI Number | 1619121043
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Entity Type | Organization
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Legal Business Name | MASON-BOSCH PARTNERS
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 1105 E SPRUCE AVE STE 203
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City | FRESNO
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State | CA
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Zip | 93720-3313
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Country | US
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Telephone | 559-450-7272
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Fax | 559-450-7276
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Provider Business Mailing Address
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Address Line | 1105 E SPRUCE AVE STE 203
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City | FRESNO
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State | CA
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Zip | 93720-3313
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Country | US
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Telephone | 559-450-7272
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Fax | 559-450-7276
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARY KATHLEEN HANSEN
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Credential |
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Telephone | 559-450-7277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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