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NPI Code Detail

MEDICARE: MR. ORLANDO A MASSINGALE

MEDICARE: MR. ORLANDO A MASSINGALE
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1598947988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ORLANDO A MASSINGALE
Provider Business Mailing Address
First Line : 1400 CARPENTIER ST APT 326
Second Line : 1400 CARPENTIER ST APT#326
City : SAN LEANDRO
State : CA
Zip : 94577-3657
Country : US
Telephone Number : 510-644-0200
Fax Number : 510-644-2044
Provider Business Practice Location Address
First Line : 2975 SACRAMENTO ST
Second Line : 2975 SACRAMENTO ST
City : BERKELEY
State : CA
Zip : 94702-2534
Country : US
Telephone Number : 510-644-0200
Fax Number : 510-644-2044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2007
Last Update Date : 11/28/2007

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Directions to “ MR. ORLANDO A MASSINGALE ” Practice Location

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