Provider Demographics
NPI:1407044233
Name:CASE, PHILIP A (CP)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:CASE
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
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Mailing Address - Street 1:1801 W OLYMPIC BLVD
Mailing Address - Street 2:FILE 1616
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91199-1616
Mailing Address - Country:US
Mailing Address - Phone:800-726-9180
Mailing Address - Fax:800-861-5950
Practice Address - Street 1:1180 W OLIVE AVE
Practice Address - Street 2:SUITE H
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1900
Practice Address - Country:US
Practice Address - Phone:209-722-2440
Practice Address - Fax:209-723-2013
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2014-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
224P00000X
CACPO02952224P00000X, 222Z00000X
CACP002624225000000X
CACP000953224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter