MEDICARE: CAROLINE MASON PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		CA

General Provider Information

NPI Number	:	1134094170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE MASON PA-C

Provider Business Mailing Address
First Line	:	535 E MAIN ST
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-4453
Country	:	US
Telephone Number	:	949-466-6055
Fax Number	:	949-281-7900

Provider Business Practice Location Address
First Line	:	535 E MAIN ST
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-4453
Country	:	US
Telephone Number	:	949-466-6055
Fax Number	:	949-281-7900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	01/06/2026

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