Healthcare Provider Details

I. General information

NPI: 1366524530
Provider Name (Legal Business Name): ADELA V CASTILLO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI MEDICAL CENTER 101 THE CITY DRIVE SOUTH
ORANGE CA
92868
US

IV. Provider business mailing address

OB/GYN UNIVERSITY ASSOCIATES PO BOX 513980
LOS ANGELES CA
90051-3980
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8978
  • Fax:
Mailing address:
  • Phone: 714-456-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number000000NP5890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: