Provider Demographics
NPI:1821184243
Name:ANTHONY M. KASSIR, M.D., A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ANTHONY M. KASSIR, M.D., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-360-9500
Mailing Address - Street 1:120 VANTIS
Mailing Address - Street 2:SUITE 540
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2676
Mailing Address - Country:US
Mailing Address - Phone:949-360-9500
Mailing Address - Fax:
Practice Address - Street 1:120 VANTIS
Practice Address - Street 2:SUITE 540
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2676
Practice Address - Country:US
Practice Address - Phone:949-360-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0616792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty