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NPI Code Detail

MEDICARE: RODRIGO LUCERO CASTELAN

MEDICARE: RODRIGO LUCERO CASTELAN
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
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1750243259
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODRIGO LUCERO CASTELAN
Provider Business Mailing Address
First Line : PO BOX 2619
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-2619
Country : US
Telephone Number : 760-924-1740
Fax Number :
Provider Business Practice Location Address
First Line : 1290 TAVERN RD
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-6601
Country : US
Telephone Number : 760-924-1740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ RODRIGO LUCERO CASTELAN ” Practice Location

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