Provider Demographics
NPI:1528600558
Name:KEVIN M CASEY MD APMC
Entity Type:Organization
Organization Name:KEVIN M CASEY MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-208-5531
Mailing Address - Street 1:1893 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7348
Mailing Address - Country:US
Mailing Address - Phone:805-351-8860
Mailing Address - Fax:805-351-8793
Practice Address - Street 1:2621 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3823
Practice Address - Country:US
Practice Address - Phone:805-456-8890
Practice Address - Fax:805-456-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1487844304Medicaid