Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC 13970 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC 13970 | CA |
NPI | 1689731556 |
---|---|
Provider Name | Dr. Philip T. Caso |
First Address | Thousand Oaks, CA 91360-5576 |
Second Address | Thousand Oaks, CA 91360-5576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 07/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TO 5202 | (02) | CA |