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NPI 1134832108

NPI 1134832108 : LAURA CASTRO CASTREZANA MD : HUNTINGTON PARK, CA

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General NPI Number Information
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    NPI Number           |    1134832108
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    Entity Type          |    Individual 
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    Provider Name        |    LAURA CASTRO CASTREZANA MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/04/2023
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    Last Update Date     |    01/04/2023
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Provider Practice Location Address
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    Address Line         |    1900 E SLAUSON AVE 
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    City                 |    HUNTINGTON PARK
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    State                |    CA
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    Zip                  |    90255-2725
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    Country              |    US
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    Telephone            |    888-499-9303
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2040 CAMFIELD AVE 
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    City                 |    COMMERCE
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    State                |    CA
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    Zip                  |    90040-1574
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    Country              |    US
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    Telephone            |    323-684-4209
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    P19
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    License Number State |    CA
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