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Individual
MR. VINCENT MARTIN CASERIO
Active
Individual
MR. VINCENT MARTIN CASERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA55670
CA
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
PA5670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1152011
NCCPA
—
01
—
PA55670
STATE LICENSE
CA
Enumeration date
06/12/2018
Last updated
12/02/2024
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