Healthcare Provider Details

I. General information

NPI: 1689731556
Provider Name (Legal Business Name): PHILIP T. CASO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 PENNSFIELD PL STE 100
THOUSAND OAKS CA
91360-5576
US

IV. Provider business mailing address

516 PENNSFIELD PL STE 100
THOUSAND OAKS CA
91360-5576
US

V. Phone/Fax

Practice location:
  • Phone: 805-373-0097
  • Fax:
Mailing address:
  • Phone: 805-373-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC 13970
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC 13970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: