MEDICARE: DR. GABRIEL CASIAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	00204399	CO

General Provider Information

NPI Number	:	1437769361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL CASIAS DDS

Provider Business Mailing Address
First Line	:	7224 MITSCHER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92145-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7224 MITSCHER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92145-2942
Country	:	US
Telephone Number	:	588-307-1824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	08/18/2023

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