MEDICARE: ROBERT J MASI MD PROFESSIONAL CORPORATION

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	207W00000X	Ophthalmology Physician	G033780	CA

General Provider Information

NPI Number	:	1659693448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT J MASI MD PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	220 MERIDIAN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2903
Country	:	US
Telephone Number	:	408-869-3400
Fax Number	:	408-947-7972

Provider Business Practice Location Address
First Line	:	220 MERIDIAN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2903
Country	:	US
Telephone Number	:	408-869-3400
Fax Number	:	408-947-7972

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT J MASI
Credential	:	MD
Telephone Number	:	408-869-3400

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	02/19/2010

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