1568752236 NPI number — MR. RODEL CACAS M.D.

Table of content: MR. RODEL CACAS M.D. (NPI 1568752236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568752236 NPI number — MR. RODEL CACAS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CACAS
Provider First Name:
RODEL
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568752236
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1341 MEADOW RIDGE CIR,
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45177-9083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-584-2459
Provider Business Mailing Address Fax Number:
937-584-4190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12459 E US 22 & STATE ROUTE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SABINA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45169-9083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-584-2459
Provider Business Practice Location Address Fax Number:
937-584-4190
Provider Enumeration Date:
04/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  122147 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1568752236 . This is a "NPI" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com