Provider Demographics
NPI:1043414246
Name:MASIKAT, JONAS CRUZ (MD)
Entity Type:Individual
Prefix:
First Name:JONAS
Middle Name:CRUZ
Last Name:MASIKAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 VALENCIA ST
Mailing Address - Street 2:#A407
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1185
Mailing Address - Country:US
Mailing Address - Phone:516-810-6381
Mailing Address - Fax:
Practice Address - Street 1:27200 CALAROGA AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4339
Practice Address - Country:US
Practice Address - Phone:510-780-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine