Active NPI
Walid Massarweh
- Neurology Physician
- Ukiah, CA
National Provider Identifier
1396867412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A43567
- Practice address
- 260 Hospial Drive
Suite 103
Ukiah, CA 95482-4533 - Phone
- (707) 463-8000
- Fax
- (707) 462-1111
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | A43567 | CA | Primary |
Addresses
Primary practice location
260 Hospial Drive
Suite 103
Ukiah, CA 95482-4533
Mailing address
260 Hospial Drive
Suite 103
Ukiah, CA 95482-4533
Phone (707) 463-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A43567 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1396867412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 HOSPIAL DRIVE",
"address_2": "SUITE 103",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824533",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 HOSPIAL DRIVE",
"address_2": "SUITE 103",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824533",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSARWEH",
"first_name": "WALID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A43567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.