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General NPI Number Information
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NPI Number | 1174796577
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Entity Type | Organization
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Legal Business Name | HUNTINGTON ASTHMA & ALLERGY CENTER A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 960 E GREEN ST STE 108
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City | PASADENA
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State | CA
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Zip | 91106-2401
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Country | US
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Telephone | 626-793-6680
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Fax | 888-475-7784
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Provider Business Mailing Address
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Address Line | 960 E GREEN ST STE 108
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City | PASADENA
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State | CA
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Zip | 91106-2401
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Country | US
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Telephone | 626-793-6680
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Fax | 888-475-7784
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Authorized Official
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Title or Position | OWNER/MD
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Name | REYNEIRO CASTRO
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Credential | MD
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Telephone | 626-793-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G15099
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A72638
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License Number State | CA
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