Healthcare Provider Details

I. General information

NPI: 1982927471
Provider Name (Legal Business Name): MIRIAM CASTRO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST DEPT OF
SAN FRANCISCO CA
94117-1019
US

IV. Provider business mailing address

450 STANYAN STREET DEPARTMENT OF ANESTHESIOLOGY
SAN FRANCISCO CA
94117
US

V. Phone/Fax

Practice location:
  • Phone: 206-818-8429
  • Fax:
Mailing address:
  • Phone: 206-818-8429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA110778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: