Doctor Name: | RYAN CASEY |
NPI Number: | 1043695463 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 95002776 |
Business Practice Address: | 444 W El Monte Way Dinuba, CA - 936181500 |
Business Phone Number: | 5595914166 |
Business Fax Number: | |
Mailing Address: | 444 W El Monte Way, DINUBA |
State: | CA |
Postal Code: | 936181500 |
Phone Number: | 5595914166 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2015 |
NPI Last Update Date: | 07/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95002776 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |