Healthcare Provider Details

I. General information

NPI: 1316457112
Provider Name (Legal Business Name): ROBERT DAVID CASAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DUARTE RD
DUARTE CA
91010-3012
US

IV. Provider business mailing address

1500 DUARTE RD
DUARTE CA
91010-3012
US

V. Phone/Fax

Practice location:
  • Phone: 877-460-4673
  • Fax:
Mailing address:
  • Phone: 877-460-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: