Healthcare Provider Details
I. General information
NPI: 1942438072
Provider Name (Legal Business Name): ANTHONY CASCONE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9864 BALDWIN PL
EL MONTE CA
91731-2202
US
IV. Provider business mailing address
3233 BROOKRIDGE RD
DUARTE CA
91010-1662
US
V. Phone/Fax
- Phone: 626-433-1311
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: