Provider Demographics
NPI:1376517664
Name:MASSION, ANN O (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:O
Last Name:MASSION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12835 POINTE DEL MAR WAY
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3846
Mailing Address - Country:US
Mailing Address - Phone:858-259-0599
Mailing Address - Fax:
Practice Address - Street 1:12835 POINTE DEL MAR WAY
Practice Address - Street 2:SUITE ONE
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3846
Practice Address - Country:US
Practice Address - Phone:858-259-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA495982084P0800X
NMMD2008-07422084P0800X
MA541272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMA J07171Medicare ID - Type Unspecified
MAB74916Medicare UPIN
MA3031811Medicaid