Provider Demographics
NPI:1801921218
Name:MASKET, HARRIS AVERY (MD)
Entity type:Individual
Prefix:
First Name:HARRIS
Middle Name:AVERY
Last Name:MASKET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5442 BOYD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1115
Mailing Address - Country:US
Mailing Address - Phone:510-368-2802
Mailing Address - Fax:
Practice Address - Street 1:100 SHORELINE HIGHWAY
Practice Address - Street 2:210A
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941
Practice Address - Country:US
Practice Address - Phone:415-388-5520
Practice Address - Fax:415-388-5503
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA74623207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine