Provider Demographics
NPI:1295728392
Name:MASSA, CHRISTOPHER SCOTT (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:MASSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 E 7TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3356
Mailing Address - Country:US
Mailing Address - Phone:530-343-5828
Mailing Address - Fax:530-345-1881
Practice Address - Street 1:185 E 7TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3356
Practice Address - Country:US
Practice Address - Phone:530-343-5828
Practice Address - Fax:530-345-1881
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA71813207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A718130Medicaid
CA00A718130Medicaid
CAH17685Medicare UPIN