Individual
EDWARD J. CACCIOPPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
27400 HESPERIAN BLVD, HAYWARD, CA 94545-4235
(510) 784-4070
(510) 184-2014
Mailing address
27400 HESPERIAN BLVD, HAYWARD, CA 94545-4235
(510) 784-4070
(510) 184-2014
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA15340
—
CA
Enumeration date
12/23/2005
Last updated
12/13/2021
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