Healthcare Provider Details

I. General information

NPI: 1821002700
Provider Name (Legal Business Name): DANIEL CASTRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 SANDSTONE DR
MORRISTOWN TN
37814-2593
US

IV. Provider business mailing address

31165 DANELAW AVE
REDLANDS CA
92373-7419
US

V. Phone/Fax

Practice location:
  • Phone: 423-616-0625
  • Fax: 423-616-0150
Mailing address:
  • Phone: 909-389-9196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD0000056844
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD0000056844
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD0000056844
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: