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General NPI Number Information
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NPI Number | 1689567349
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Entity Type | Individual
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Provider Name | BRYAN STEPHEN CASTILLO
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Gender | Male
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 235 E BADILLO ST
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City | COVINA
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State | CA
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Zip | 91723-2116
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Country | US
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Telephone | 626-915-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 11023 COUNTRYVIEW DR
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-6699
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Country | US
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Telephone | 818-797-8528
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95027099
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95035538
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License Number State | CA
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