Healthcare Provider Details

I. General information

NPI: 1407044233
Provider Name (Legal Business Name): PHILIP A CASE CP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 W OLIVE AVE SUITE H
MERCED CA
95348-1900
US

IV. Provider business mailing address

1801 W OLYMPIC BLVD FILE 1616
PASADENA CA
91199-1616
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-2440
  • Fax: 209-723-2013
Mailing address:
  • Phone: 800-726-9180
  • Fax: 800-861-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCPO02952
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCP000953
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCPO02952
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCP000953
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberCP002624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: