Provider Demographics
NPI:1467420273
Name:CASCIARI, RAYMOND J (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:J
Last Name:CASCIARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1310 W STEWART DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:714-639-9401
Mailing Address - Fax:714-639-7095
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:SUITE 410
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-639-9401
Practice Address - Fax:714-639-7095
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG27215207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG27215OtherSTATE LICENSE NUMBER
CAG27215OtherSTATE LICENSE NUMBER
CAA43274Medicare UPIN