Provider Demographics
NPI:1295559144
Name:MASANNAT, RULA
Entity type:Individual
Prefix:
First Name:RULA
Middle Name:
Last Name:MASANNAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 KENWAL RD APT C
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3858
Mailing Address - Country:US
Mailing Address - Phone:415-310-2905
Mailing Address - Fax:
Practice Address - Street 1:1235 KENWAL RD APT C
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3858
Practice Address - Country:US
Practice Address - Phone:415-310-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty