Healthcare Provider Details

I. General information

NPI: 1437100955
Provider Name (Legal Business Name): DAVID CAISEDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW 3RD FLOOR
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

PO BOX 418283
BOSTON MA
02241-8283
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8207
  • Fax: 877-544-7752
Mailing address:
  • Phone: 202-444-8207
  • Fax: 877-544-7752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12472
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: