Basic Information
| Provider Information | |||||||||
| NPI: | 1508933607 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASSA | ||||||||
| FirstName: | BONNI | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WEBSTER ST | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159233123 | ||||||||
| FaxNumber: | 4159233132 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 WEBSTER ST | ||||||||
| Address2: | SUITE 319 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159233123 | ||||||||
| FaxNumber: | 4159233132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 01/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | A67511 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VX0000X | A67511 | CA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.