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General NPI Number Information
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NPI Number | 1538448196
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Entity Type | Individual
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Provider Name | RAYNATO OCAMPO CASTRO JR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 2089 VALE RD STE 30
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City | SAN PABLO
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State | CA
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Zip | 94806-3847
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Country | US
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Telephone | 510-236-1662
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 KILDARE WAY
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City | PINOLE
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State | CA
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Zip | 94564-2712
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Country | US
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Telephone | 510-260-4943
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60586
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License Number State | CA
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