Basic Information
| Provider Information | |||||||||
| NPI: | 1841247145 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASON | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Practice Location | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 05/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | C36997 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | CH1382 | 01 | CA | RAILROAD MEDICARE | OTHER | M050376 | 01 | CA | GROUP | OTHER | DA6447 | 01 | CA | RAILROAD MEDICARE | OTHER | 00C369970 | 05 | CA | MEDICAID | W14940 | 01 | CA | GROUP | OTHER |