Provider Demographics
NPI:1063721041
Name:CAISSE, MICHAEL (DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CAISSE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GARDEN VIEW CT
Mailing Address - Street 2:STE 103
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2478
Mailing Address - Country:US
Mailing Address - Phone:760-632-6942
Mailing Address - Fax:
Practice Address - Street 1:700 GARDEN VIEW CT
Practice Address - Street 2:STE 103
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2478
Practice Address - Country:US
Practice Address - Phone:760-632-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37146OtherPHYSICAL THERAPIST ID