Healthcare Provider Details

I. General information

NPI: 1447281746
Provider Name (Legal Business Name): CASTLE FAMILY HEALTH CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6029 N WINTON WAY
WINTON CA
95388-9515
US

IV. Provider business mailing address

6029 N WINTON WAY
WINTON CA
95388-9515
US

V. Phone/Fax

Practice location:
  • Phone: 209-357-7755
  • Fax: 209-722-9020
Mailing address:
  • Phone: 209-357-7755
  • Fax: 209-722-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD LUJANO
Title or Position: CEO
Credential: DBA
Phone: 209-381-2000