Provider Demographics
NPI:1649209818
Name:CHRISTOPHER E MASON FRESNO PHYSICAL THERAPY
Entity Type:Organization
Organization Name:CHRISTOPHER E MASON FRESNO PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:559-227-4440
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:93726-4040
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DN3860OtherRAILROAD MEDICARE
CA610747200OtherUS DEP. OF LAB AG FORESTR
CAZZZ02704ZMedicare PIN