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General NPI Number Information
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NPI Number | 1639211733
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Entity Type | Individual
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Provider Name | ANTHONY J. MASCOLA MD
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | UC IRVINE 501 STUDENT HEALTH
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City | IRVINE
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State | CA
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Zip | 92697-5200
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Country | US
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Telephone | 949-824-5301
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Fax | 949-824-0323
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Provider Business Mailing Address
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Address Line | 20331 IRVINE AVENUE, E1
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-230-0830
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Fax | 844-461-6788
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A78155
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License Number State | CA
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