MEDICARE: JOSE AALBERTO CASTANEDA D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor	DC11872	CA

General Provider Information

NPI Number	:	1346392370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE AALBERTO CASTANEDA D.C.

Provider Business Mailing Address
First Line	:	718 N. EUCLID AVE.
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-3427
Country	:	US
Telephone Number	:	909-391-2789
Fax Number	:	909-391-3446

Provider Business Practice Location Address
First Line	:	718 N. EUCLID AVE.
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-3427
Country	:	US
Telephone Number	:	909-391-2789
Fax Number	:	909-391-3446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2007

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