Healthcare Provider Details

I. General information

NPI: 1063656114
Provider Name (Legal Business Name): WILLIAM H CASTRO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18699 N 67TH AVE STE 320
GLENDALE AZ
85308-7140
US

IV. Provider business mailing address

18699 N 67TH AVE STE 360
GLENDALE AZ
85308-7140
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-3100
  • Fax: 623-334-9125
Mailing address:
  • Phone: 623-412-3100
  • Fax: 623-334-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number18402
License Number StateAZ

VIII. Authorized Official

Name: WILLIAM H CASTRO
Title or Position: PRESIDENT
Credential: MD
Phone: 623-412-3100