Provider Demographics
NPI:1851667950
Name:MASON, BYRON MICHAEL (LVN)
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:MICHAEL
Last Name:MASON
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33600 MAPLETON AVE
Mailing Address - Street 2:SUITE #C2122
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4471
Mailing Address - Country:US
Mailing Address - Phone:619-906-9907
Mailing Address - Fax:951-699-1838
Practice Address - Street 1:33600 MAPLETON AVE
Practice Address - Street 2:SUITE #C2122
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4471
Practice Address - Country:US
Practice Address - Phone:619-906-9907
Practice Address - Fax:951-699-1838
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA249089164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse