Provider Demographics
NPI:1063673994
Name:CASIPIT, ROY
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:CASIPIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 TEMECULA CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9511
Mailing Address - Country:US
Mailing Address - Phone:209-723-3085
Mailing Address - Fax:209-723-3085
Practice Address - Street 1:3534 TEMECULA CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-9511
Practice Address - Country:US
Practice Address - Phone:209-723-3085
Practice Address - Fax:209-723-3085
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247204069177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging