Healthcare Provider Details

I. General information

NPI: 1407521818
Provider Name (Legal Business Name): MELISSA CASTELLANOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 IMPERIAL HWY
DOWNEY CA
90242-2813
US

IV. Provider business mailing address

6920 E 11TH ST
LONG BEACH CA
90815-4936
US

V. Phone/Fax

Practice location:
  • Phone: 562-922-6111
  • Fax:
Mailing address:
  • Phone: 323-245-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: