Healthcare Provider Details

I. General information

NPI: 1962723916
Provider Name (Legal Business Name): RHINA DENISSE CASTILLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2010
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD MAILBOX 60
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

4650 W SUNSET BLVD MAILSTOP 60
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-8232
  • Fax:
Mailing address:
  • Phone: 323-361-2119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA112031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: