Provider Demographics
NPI:1487845756
Name:ROBERT F. KASA MD PC
Entity Type:Organization
Organization Name:ROBERT F. KASA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ADELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-518-5900
Mailing Address - Street 1:500 N FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4427
Mailing Address - Country:US
Mailing Address - Phone:520-518-5900
Mailing Address - Fax:520-518-5901
Practice Address - Street 1:500 N FLORENCE ST
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4427
Practice Address - Country:US
Practice Address - Phone:520-518-5900
Practice Address - Fax:520-518-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ242016Medicaid
AZ242016Medicaid