Provider Demographics
NPI:1396060992
Name:CASARES, SCOTT (DPT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:CASARES
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 1:1235 PEAR AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1444
Mailing Address - Country:US
Mailing Address - Phone:650-965-8434
Mailing Address - Fax:650-965-8545
Practice Address - Street 1:1235 PEAR AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1444
Practice Address - Country:US
Practice Address - Phone:650-965-8434
Practice Address - Fax:650-965-8545
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist