Provider Demographics
NPI:1457447112
Name:SANJAY MASSON MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SANJAY MASSON MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-624-3323
Mailing Address - Street 1:P.O.BOX 6998
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290
Mailing Address - Country:US
Mailing Address - Phone:559-624-3323
Mailing Address - Fax:559-734-7713
Practice Address - Street 1:1100 SOUTH AKERS ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-624-3323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA902582084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7431541140OtherCIGNA
CA=========OtherUS BEHAVIORAL HEALTH PC
CA=========OtherUNITED BEHAVIORAL HEALTH
CA=========OtherFOUNDATION
CA7431541140OtherCIGNA
CA=========OtherPACIFIC CARE BEHAVIORAL H
CA=========OtherCHIPA
CA=========OtherBLUE CROSS OF CA
CA=========OtherAETNA
CA=========OtherTRI-WEST
CA=========OtherVALUE OPTIONS