Healthcare Provider Details

I. General information

NPI: 1841557733
Provider Name (Legal Business Name): DAVID ANDRES CASTRO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID ANDRES CASTRO GOTTSCHALK

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 11/01/2023
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 OUTER RD
SAN DIEGO CA
92154-1351
US

IV. Provider business mailing address

819 D AVE UNIT 209
NATIONAL CITY CA
91950-3404
US

V. Phone/Fax

Practice location:
  • Phone: 619-429-3733
  • Fax:
Mailing address:
  • Phone: 314-874-6596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.013012
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4264
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC36311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: