Provider Demographics
NPI:1275509986
Name:MASON, CHRISTOPHER EUGENE (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EUGENE
Last Name:MASON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 N FRESNO ST
Mailing Address - Street 2:#106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4033
Mailing Address - Country:US
Mailing Address - Phone:559-227-4440
Mailing Address - Fax:559-227-4443
Practice Address - Street 1:4005 N FRESNO ST
Practice Address - Street 2:#106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4033
Practice Address - Country:US
Practice Address - Phone:559-227-4440
Practice Address - Fax:559-227-4443
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00617621OtherRAILROAD MEDICARE
P00617621OtherRAILROAD MEDICARE