Healthcare Provider Details

I. General information

NPI: 1073604633
Provider Name (Legal Business Name): CRAIG YUICHI CASTILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S KING ST STE 804
HONOLULU HI
96814
US

IV. Provider business mailing address

746 KAULANA PL
HONOLULU HI
96821-2535
US

V. Phone/Fax

Practice location:
  • Phone: 808-593-0177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD-7240
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD7240
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: