Masseray Bangura, PA

Individual provider Active NPI Physician Assistant · South Gate, CA

NPI 1689213639 · NPPES record last updated Dec 21, 2019

Key facts

NPI
1689213639
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
5158 Wood Ave
South Gate, CA 90280-5236
Phone
(928) 575-6995
NPI assigned
Dec 21, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Yes

Addresses

Primary practice location

5158 Wood Ave
South Gate, CA 90280-5236

Mailing address

5158 Wood Ave
South Gate, CA 90280-5236

Other providers in South Gate, CA

All providers in South Gate, CA · Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.