Provider Demographics
NPI:1093606220
Name:MASIUK, KATELYN (MD PHD)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:
Last Name:MASIUK
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 STANFORD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-6876
Mailing Address - Country:US
Mailing Address - Phone:724-466-3848
Mailing Address - Fax:
Practice Address - Street 1:1527 STANFORD ST APT 5
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-6876
Practice Address - Country:US
Practice Address - Phone:724-466-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program