Provider Demographics
NPI:1548458466
Name:MASRI, TONY (MD)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:MASRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 POLLARD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1435
Mailing Address - Country:US
Mailing Address - Phone:408-866-3927
Mailing Address - Fax:408-866-3843
Practice Address - Street 1:825 POLLARD RD STE 100
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1435
Practice Address - Country:US
Practice Address - Phone:408-866-3927
Practice Address - Fax:408-866-3843
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1168942084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1548458466OtherNPI
CA1548458466OtherNPI
CAFZ783YMedicare PIN
CAFZ783XMedicare PIN