Provider Demographics
NPI:1942275672
Name:MASKA, PATRICIA SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SUZANNE
Last Name:MASKA
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 1:985 ATLANTIC AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6446
Mailing Address - Country:US
Mailing Address - Phone:510-748-5363
Mailing Address - Fax:510-748-5425
Practice Address - Street 1:985 ATLANTIC AVE STE 300
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6446
Practice Address - Country:US
Practice Address - Phone:510-748-5363
Practice Address - Fax:510-745-5425
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA947852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A947850Medicare PIN
MDI22399Medicare UPIN