Mohammad Masum, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

812981 Issued in TX

Practice address

101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809

Phone

(707) 816-5773

NPI assigned

Nov 21, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1215752407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CANNON DR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351143",
            "telephone_number": "707-690-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-816-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUM",
        "first_name": "MOHAMMAD",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "812981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Scott Martineau, M.D.
• Martinez Vamc
• Brooke Martinez
• Gary L Martinsen, OD, PHD
• Mitchell Marubayashi, D.O.
• Peter E Matthews, MD
• William Ken McCallum, MD
• Lawrence Patrick McCarthy, DDS
• Christopher O'Neal McCarty, CRNA, DNP
• Lauren McCullough, PTA

• Registered Nurse in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.