Provider Demographics
NPI:1689731556
Name:CASO, PHILIP T (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:T
Last Name:CASO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 PENNSFIELD PL STE 100
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5576
Mailing Address - Country:US
Mailing Address - Phone:805-373-0097
Mailing Address - Fax:
Practice Address - Street 1:516 PENNSFIELD PL STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5576
Practice Address - Country:US
Practice Address - Phone:805-373-0097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 13970111NN0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 13970 BMedicare ID - Type Unspecified
CATO 5202Medicare UPIN