Healthcare Provider Details

I. General information

NPI: 1467529321
Provider Name (Legal Business Name): PHILLIP CASTELLANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12460 EUCLID ST STE 101
GARDEN GROVE CA
92840-3351
US

IV. Provider business mailing address

12460 EUCLID ST STE 101
GARDEN GROVE CA
92840-3351
US

V. Phone/Fax

Practice location:
  • Phone: 714-530-2183
  • Fax: 949-629-7764
Mailing address:
  • Phone: 714-530-2183
  • Fax: 949-629-7764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA64422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: