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General NPI Number Information
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NPI Number | 1669533642
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Entity Type | Organization
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Legal Business Name | MASSEN MEDICAL INC.
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 19682 HESPERIAN BLVD STE 101A
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City | HAYWARD
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State | CA
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Zip | 94541-4752
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Country | US
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Telephone | 510-783-0536
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Fax | 510-315-1103
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Provider Business Mailing Address
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Address Line | 19682 HESPERIAN BLVD STE 101A
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City | HAYWARD
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State | CA
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Zip | 94541-4752
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Country | US
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Telephone | 510-783-0536
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Fax | 510-315-1103
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. ARKADY MASSEN
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Credential | M.D.
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Telephone | 510-783-0536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 00A527260
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License Number State | CA
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