Individual
GENESIS CASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 E 2ND ST, POMONA, CA 91766-1854
(909) 623-6116
Mailing address
8635 BANDERA ST, LOS ANGELES, CA 90002-1408
(323) 774-2334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA63280
CA
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
06/05/2023
Last updated
09/20/2024
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