Provider Demographics
NPI:1659670784
Name:CECILIA KAESLER, D.O., INC.
Entity type:Organization
Organization Name:CECILIA KAESLER, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:TSANG
Authorized Official - Last Name:KAESLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-790-0357
Mailing Address - Street 1:1113 FOOTHILL BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011
Mailing Address - Country:US
Mailing Address - Phone:818-790-0357
Mailing Address - Fax:
Practice Address - Street 1:1113 FOOTHILL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3207
Practice Address - Country:US
Practice Address - Phone:818-790-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A6257OtherMEDICAL LICENSE
1326092891OtherNPI
1326092891OtherNPI