Casillas, Jacqueline Nieto
Casillas, Jacqueline Nieto is an individual health care provider with primary practice located at 10833 Le Conte Ave A2-410 Mdcc, Los Angeles CA 90095-3075. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Casillas, Jacqueline Nieto can be contacted via phone (310) 206-3952.Contact Information
Primary practice address
10833 Le Conte Ave A2-410 Mdcc
Los Angeles CA 90095-3075
Phone: (310) 206-3952
Fax: (310) 206-0209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | A62861 | California |
Profile Details
| NPI number | 1790707065 |
|---|---|
| LBN Legal business name | Casillas, Jacqueline Nieto |
| Credentials | M.D., M.S.H.S |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Apr 4th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790707065 | NPPES |
| California | MEDICAID | GR0053510 | |
| California | MEDICAID | 00A628610 |
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