Revenko, Casey S
Revenko, Casey S is an individual health care provider with primary practice located at 2999 Regent St Ste 225 , Berkeley CA 94705-2117. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Revenko, Casey S can be contacted via phone (510) 704-7760.Contact Information
Primary practice address
2999 Regent St Ste 225
Berkeley CA 94705-2117
Phone: (510) 704-7760
Fax: (510) 704-7765
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | PA56633 | California |
Profile Details
| NPI number | 1790341618 |
|---|---|
| LBN Legal business name | Revenko, Casey S |
| Credentials | PHYSICIAN ASSISTANT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2019 |
| Last updated | May 21st, 2019 - about 6 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.
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