Healthcare Provider Details

I. General information

NPI: 1760485205
Provider Name (Legal Business Name): JOHN A KASCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 CAPITOL AVE
SACRAMENTO CA
95816-6004
US

IV. Provider business mailing address

720 SAN RAMON WAY
SACRAMENTO CA
95864-5230
US

V. Phone/Fax

Practice location:
  • Phone: 916-446-5053
  • Fax: 916-446-0500
Mailing address:
  • Phone: 916-446-5053
  • Fax: 916-446-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG27391
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberG27391
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberG27391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: