Provider Demographics
NPI:1528001641
Name:MASEK, CODY (DC)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:
Last Name:MASEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31217 PAUBA RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6221
Mailing Address - Country:US
Mailing Address - Phone:951-693-5629
Mailing Address - Fax:951-693-4197
Practice Address - Street 1:31217 PAUBA RD
Practice Address - Street 2:SUITE 204
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6221
Practice Address - Country:US
Practice Address - Phone:951-693-5629
Practice Address - Fax:951-693-4197
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor