MEDICARE: MYLA DECASTRO MBA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	372600000X	Adult Companion	CA
2	3747A0650X	Attendant Care Provider	CA
3	374U00000X	Home Health Aide	CA
4	376G00000X	Nursing Home Administrator	CA

General Provider Information

NPI Number	:	1518818699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYLA DECASTRO MBA

Provider Business Mailing Address
First Line	:	1865 E WOODGATE DR
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-1953
Country	:	US
Telephone Number	:	626-361-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1865 E WOODGATE DR
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-1953
Country	:	US
Telephone Number	:	626-361-5900
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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