MEDICARE: DIPTI VERONICA MASIH LVN

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	164X00000X	Licensed Vocational Nurse	293201	CA

General Provider Information

NPI Number	:	1164199485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIPTI VERONICA MASIH LVN

Provider Business Mailing Address
First Line	:	7246 REMMET AVE
Second Line	:
City	:	CANOGA PARK
State	:	CA
Zip	:	91303-1531
Country	:	US
Telephone Number	:	818-206-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	AEGIS TREATMENT CENTRE
Second Line	:	1018 , 21ST STREET
City	:	BAKERSFIELD
State	:	CA
Zip	:	93303
Country	:	US
Telephone Number	:	661-322-0965
Fax Number	:

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

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	08/25/2021

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