MEDICARE: KEVIN M CASEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	A107608	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A107608	OTHER	CA	MEDICAL BOARD OF CA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487844304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M CASEY MD

Provider Business Mailing Address
First Line	:	PO BOX 1206
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93116-1206
Country	:	US
Telephone Number	:	619-532-7580
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 W JUNIPERO ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4212
Country	:	US
Telephone Number	:	805-730-1470
Fax Number	:	805-730-1473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	10/12/2019

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