Healthcare Provider Details

I. General information

NPI: 1588758759
Provider Name (Legal Business Name): RAJEEV KASSAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 LANA DR STE D
CAMERON MO
64429-1473
US

IV. Provider business mailing address

1004 ROSEWOOD DR
CAMERON MO
64429-1276
US

V. Phone/Fax

Practice location:
  • Phone: 816-632-4500
  • Fax: 816-632-4501
Mailing address:
  • Phone: 660-349-0869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2001011414
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: