Provider Demographics
NPI:1427444298
Name:CASARES, ESTANISLAO II
Entity type:Individual
Prefix:
First Name:ESTANISLAO
Middle Name:
Last Name:CASARES
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E COOK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5748
Mailing Address - Country:US
Mailing Address - Phone:805-406-2530
Mailing Address - Fax:
Practice Address - Street 1:1025 E OCEAN AVE STE B
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7088
Practice Address - Country:US
Practice Address - Phone:805-819-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker