Provider Demographics
NPI:1922358308
Name:MASSE, ELLEN BIERLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:BIERLEY
Last Name:MASSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20511 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-3433
Mailing Address - Country:US
Mailing Address - Phone:818-800-8808
Mailing Address - Fax:818-912-6173
Practice Address - Street 1:20511 WELLS DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-3433
Practice Address - Country:US
Practice Address - Phone:818-800-8808
Practice Address - Fax:818-912-6173
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA22230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine