Organization
JEREMY E KASLOW, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY E KASLOW M.D. (PRESIDENT)
(714) 565-1032
Entity
Organization
Contact information
Practice address
720 N TUSTIN AVE, SUITE 206, SANTA ANA, CA 92705-3606
(714) 565-1032
(714) 565-1035
Mailing address
720 N TUSTIN AVE, SUITE 206, SANTA ANA, CA 92705-3606
(714) 565-1032
(714) 565-1035
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
G55911
CA
261QM2500X
Medical Specialty Clinic/Center
G55911
CA
261QP2000X
Physical Therapy Clinic/Center
Primary
G55911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G55911
STATE LICENSURE
CA
Enumeration date
06/20/2007
Last updated
09/11/2025
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