Gordon David Mason and Emily Sue Mason

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GORDON DAVID MASON AND EMILY SUE MASON

Doing business as

Mason Physical Therapy

Practice address

6840 Indiana Ave
Suite 130
Riverside, CA 92506-4298

Phone

(951) 682-4176

Fax

(951) 682-4188

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gordon David Mason

Title

Owner / Administrator

Phone

(951) 682-4176

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mason Physical Therapy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily Rachel Lee, PT DPT

  • Physical Therapist
  • Menifee, CA
  • NPI 1679658819
  NPD (past)
• Kelly Miranda, PA-C, MPT

  • Physician Assistant
  • Moreno Valley, CA
  • NPI 1578671558

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982630182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 INDIANA AVE",
            "address_2": "SUITE 130",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064298",
            "telephone_number": "951-682-4176",
            "fax_number": "951-682-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 INDIANA AVE",
            "address_2": "SUITE 130",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064298",
            "telephone_number": "951-682-4176",
            "fax_number": "951-682-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON DAVID MASON AND EMILY SUE MASON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER / ADMINISTRATOR",
        "authorized_official_telephone_number": "951-682-4176",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ66551Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mason Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sie Kegan Goodwin, NONE
• Ashley Goot
• Gordian Medical IV, Inc.
• Rachel Leanne Gordillo
• Gordon David Mason
• Bobbi-Ann M Gordon
• Deborah J Gordon, NP
• Donna Marie Gordon
• Glenda Gordon
• Jennifer A Gordon, CADC-II

• Physical Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.