Individual
THEODORE D. MASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77840 FLORA RD, PALM DESERT, CA 92211-4109
(760) 200-8777
(760) 200-8877
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A39531
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A395310
—
CA
01
—
P00253432
RAILROAD MEDICARE
CA
Enumeration date
09/14/2005
Last updated
08/07/2008
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