Healthcare Provider Details

I. General information

NPI: 1003051954
Provider Name (Legal Business Name): MARIA DEL CARMEN CASTILLO N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA CASTILLO N.P.

II. Dates (important events)

Enumeration Date: 12/06/2008
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 E 1ST ST
LOS ANGELES CA
90063-2807
US

IV. Provider business mailing address

9723 MAXINE ST
PICO RIVERA CA
90660-5308
US

V. Phone/Fax

Practice location:
  • Phone: 323-262-6935
  • Fax: 323-262-3109
Mailing address:
  • Phone: 562-949-1440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN403433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: