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General NPI Number Information
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NPI Number | 1245945203
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Entity Type | Organization
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Legal Business Name | PRACTICALMED INC
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 5405 W HILLSDALE AVE
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City | VISALIA
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State | CA
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Zip | 93291-5156
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Country | US
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Telephone | 559-556-5591
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Fax | 888-720-1716
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Provider Business Mailing Address
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Address Line | 5405 W HILLSDALE AVE
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City | VISALIA
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State | CA
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Zip | 93291-5156
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Country | US
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Telephone | 559-556-5591
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Fax | 888-720-1716
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Authorized Official
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Title or Position | OWNER
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Name | FAUSTO CASTILLO
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Credential |
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Telephone | 323-979-9404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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