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General NPI Number Information
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NPI Number | 1265788426
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Entity Type | Organization
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Legal Business Name | SAM A CASTRO, M.D., INC.
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 333 W SHAW AVE #7
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City | FRESNO
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State | CA
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Zip | 93704-2657
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Country | US
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Telephone | 559-221-6864
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Fax | 559-221-8917
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Provider Business Mailing Address
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Address Line | 333 W SHAW AVE #7
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City | FRESNO
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State | CA
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Zip | 93704-2657
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Country | US
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Telephone | 559-221-6864
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Fax | 559-221-8917
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAM A CASTRO
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Credential | M.D.
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Telephone | 559-221-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | CO15434
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License Number State | CA
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