Provider Demographics
NPI:1659628071
Name:KASS MEDICAL HOLDINGS INC
Entity Type:Organization
Organization Name:KASS MEDICAL HOLDINGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:KASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-926-3311
Mailing Address - Street 1:7104 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4417
Mailing Address - Country:US
Mailing Address - Phone:952-926-3311
Mailing Address - Fax:952-922-4492
Practice Address - Street 1:12646 CUMPSTON ST
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-1914
Practice Address - Country:US
Practice Address - Phone:952-926-3311
Practice Address - Fax:952-922-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty