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General NPI Number Information
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NPI Number | 1356766869
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Entity Type | Organization
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Legal Business Name | PETER A. CASTILLO, MD, INC.
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 16070 MATILIJA DR
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City | LOS GATOS
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State | CA
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Zip | 95030-3083
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Country | US
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Telephone | 415-764-4800
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Fax | 415-764-4802
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Provider Business Mailing Address
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Address Line | 16070 MATILIJA DR
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City | LOS GATOS
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State | CA
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Zip | 95030-3083
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Country | US
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Telephone | 415-764-4800
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Fax | 415-764-4802
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER A. CASTILLO
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Credential | M.D.
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Telephone | 415-764-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 109681
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License Number State | CA
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