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General NPI Number Information
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NPI Number | 1497734404
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Entity Type | Individual
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Provider Name | MICHAEL D KASSIS P.T.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 1350 BURTON DR 260
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City | VACAVILLE
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State | CA
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Zip | 95687-3539
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Country | US
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Telephone | 707-449-3484
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Fax | 707-449-1803
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Provider Business Mailing Address
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Address Line | 1350 BURTON DR 260
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City | VACAVILLE
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State | CA
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Zip | 95687-3539
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Country | US
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Telephone | 707-449-3484
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Fax | 707-449-1803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT20690
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License Number State | CA
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