MEDICARE: CALM HORIZONS PSYCHIATRY PC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1932941051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALM HORIZONS PSYCHIATRY PC

Provider Business Mailing Address
First Line	:	1650 GARNET AVE # 1001
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3116
Country	:	US
Telephone Number	:	619-736-3985
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 NOYES ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3637
Country	:	US
Telephone Number	:	619-736-3985
Fax Number	:	619-736-5991

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT MASONER
Credential	:	MD
Telephone Number	:	623-451-2057

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/10/2024

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