MEDICARE: DR. SHEIKH MOHAMMAD MASOOD M.D.

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	207RN0300X	Nephrology Physician	27488	AZ
2	207RN0300X	Nephrology Physician	C52769	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C52769	OTHER	CA	MEDICAL LICENCE

General Provider Information

NPI Number	:	1669422812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEIKH MOHAMMAD MASOOD M.D.

Provider Business Mailing Address
First Line	:	451 E ALMOND AVE
Second Line	:	STE 101
City	:	MADERA
State	:	CA
Zip	:	93637-5562
Country	:	US
Telephone Number	:	559-661-1959
Fax Number	:	559-661-1952

Provider Business Practice Location Address
First Line	:	451 E ALMOND AVE
Second Line	:	STE 101
City	:	MADERA
State	:	CA
Zip	:	93637-5562
Country	:	US
Telephone Number	:	559-661-1965
Fax Number	:	559-661-1952

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/18/2018

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