Healthcare Provider Details

I. General information

NPI: 1164414405
Provider Name (Legal Business Name): DANIELA V CASTANEDA PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 12TH AVE
COLUMBUS OH
43210-1214
US

IV. Provider business mailing address

1420 ASCHINGER BLVD
COLUMBUS OH
43212-2690
US

V. Phone/Fax

Practice location:
  • Phone: 915-274-4608
  • Fax:
Mailing address:
  • Phone: 915-274-4608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number43451
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: