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General NPI Number Information
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NPI Number | 1609707728
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Entity Type | Individual
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Provider Name | MARLON ANGQUICO CASTILLO
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Gender | Male
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 14541 DELANO ST
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City | VAN NUYS
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State | CA
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Zip | 91411-2820
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Country | US
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Telephone | 310-292-6065
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Fax |
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Provider Business Mailing Address
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Address Line | 14541 DELANO ST
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City | VAN NUYS
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State | CA
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Zip | 91411-2820
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Country | US
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Telephone | 310-292-6065
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 757574
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License Number State | CA
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