Healthcare Provider Details

I. General information

NPI: 1235147554
Provider Name (Legal Business Name): CARIN R CASTRO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 N 75TH AVE STE 104
PHOENIX AZ
85035-1200
US

IV. Provider business mailing address

4619 N 24TH ST
PHOENIX AZ
85016-5203
US

V. Phone/Fax

Practice location:
  • Phone: 623-849-9416
  • Fax: 623-849-9622
Mailing address:
  • Phone: 602-956-0111
  • Fax: 602-956-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7746
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: