Provider Demographics
NPI:1285727842
Name:CASHA, MARK S (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:CASHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5330 PRIMROSE DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3520
Mailing Address - Country:US
Mailing Address - Phone:916-967-7436
Mailing Address - Fax:916-796-7745
Practice Address - Street 1:5330 PRIMROSE DR
Practice Address - Street 2:SUITE 140
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3520
Practice Address - Country:US
Practice Address - Phone:916-967-7436
Practice Address - Fax:916-796-7756
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0148330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0148330Medicare ID - Type Unspecified
CAT05522Medicare UPIN