Provider Demographics
NPI:1689333502
Name:DR MASON LANG OD, INC
Entity type:Organization
Organization Name:DR MASON LANG OD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-456-5848
Mailing Address - Street 1:500 PAWNEE PL
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3306
Mailing Address - Country:US
Mailing Address - Phone:510-456-5848
Mailing Address - Fax:
Practice Address - Street 1:30600 DYER ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1717
Practice Address - Country:US
Practice Address - Phone:510-431-3142
Practice Address - Fax:510-324-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty