Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A108891 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A108891 | CA |
NPI | 1235380429 |
---|---|
Provider Name | Dr. Misha R Kassel |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 08/07/2011 |