Provider Demographics
NPI:1144376740
Name:MASNY, PETER SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:SEBASTIAN
Last Name:MASNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:850 FAIR OAKS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3929
Mailing Address - Country:US
Mailing Address - Phone:805-547-2224
Mailing Address - Fax:805-474-5276
Practice Address - Street 1:850 FAIR OAKS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3929
Practice Address - Country:US
Practice Address - Phone:805-547-2224
Practice Address - Fax:805-547-2228
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1131362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology