Healthcare Provider Details

I. General information

NPI: 1558062612
Provider Name (Legal Business Name): CASTRO CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/26/2023
Certification Date: 03/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 ROSECRANS AVE STE 106
NORWALK CA
90650-3881
US

IV. Provider business mailing address

11550 ROSECRANS AVE STE 106
NORWALK CA
90650-3881
US

V. Phone/Fax

Practice location:
  • Phone: 562-474-1314
  • Fax: 562-735-0205
Mailing address:
  • Phone: 562-474-1314
  • Fax: 562-735-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS CASTRO
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 562-293-3336