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General NPI Number Information
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NPI Number | 1871722132
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Entity Type | Organization
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Legal Business Name | BARRY PAUL KASSELS M D INC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 1700 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-2803
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Country | US
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Telephone | 503-372-2740
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 SW NIMBUS AVE STE 200
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City | BEAVERTON
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State | OR
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Zip | 97008-7389
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Country | US
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Telephone | 503-372-2740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY PAUL KASSELS
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Credential | M D
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Telephone | 209-484-4368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G78198
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License Number State | CA
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