Healthcare Provider Details

I. General information

NPI: 1124386834
Provider Name (Legal Business Name): FRANCISCO CASTRO B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 07/02/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N. PRAIRIE AVE. INGLEWOOD, CA SUITE 511
INGLEWOOD CA
90301
US

IV. Provider business mailing address

301 N. PRAIRIE AVE. INGLEWOOD, CA SUITE 511
INGLEWOOD CA
90301
US

V. Phone/Fax

Practice location:
  • Phone: 818-619-5088
  • Fax:
Mailing address:
  • Phone: 818-619-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: