Provider Demographics
NPI:1871254318
Name:COBARRINOAS, KASIMIR GEORI
Entity type:Individual
Prefix:
First Name:KASIMIR
Middle Name:GEORI
Last Name:COBARRINOAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 VISTAVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2459
Mailing Address - Country:US
Mailing Address - Phone:669-225-9753
Mailing Address - Fax:
Practice Address - Street 1:3450 VISTAVIEW DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-2459
Practice Address - Country:US
Practice Address - Phone:669-225-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9093389OtherKAISER