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NPI Code Detail

MEDICARE: DORISHA MASON

MEDICARE: DORISHA MASON
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1669973004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORISHA MASON
Provider Business Mailing Address
First Line : 1312 S 8TH ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1638
Country : US
Telephone Number : 702-385-0920
Fax Number : 702-474-6340
Provider Business Practice Location Address
First Line : 1312 S 8TH ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1638
Country : US
Telephone Number : 702-385-0920
Fax Number : 702-474-6340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2018
Last Update Date : 02/21/2018

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Directions to “ DORISHA MASON ” Practice Location

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