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Stephen Ranjit Masillamoni

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3020 Childrens Way, San Diego, CA 92123-4223

PECOS Enrollment

This provider is enrolled in PECOS as STEPHEN MASILLAMONI.

Based on the most recent information from CMS, provider Stephen Ranjit Masillamoni is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1730567850
Provider Type
Individual
Full Name
Masillamoni, Stephen Ranjit
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/8/2015
Last Updated
4/30/2024

Contact Information

Practice Location

3020 Childrens Way, San Diego, CA 92123-4223

(858) 576-1700

Unlisted Fax

Mailing Location

240 E 24th St, Yuma, AZ 85364-8547

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0804X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD-21657 Hawaii
Code 2084P0804X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 286357 Massachusetts
Code 2084P0804X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License D85328 Maryland
Code 2084P0804X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A171232 California
Code 2084P0804X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD61113936 Washington
Code 2084P0804X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 0101270929 Virginia

Stephen Ranjit Masillamoni

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Do, Natalie Tram

Sheridan, Joseph J

Mcginley, Nancy Rodriguez

Patel, Karishma

Joseph Kosmach Do Pc

Chory, Kayla Alvine

Morrison, Tyler Edwards

Hall, Joseph Robert

Solway, Karen E

Rabin, Allan H.