Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 27418 | AZ |
NPI | 1891793956 |
---|---|
Provider Name | Robert F Kasa |
First Address | Casa Grande, AZ 85122-4427 |
Second Address | Casa Grande, AZ 85122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 21/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Z242016 | (05) | AZ |