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General NPI Number Information
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NPI Number | 1720773609
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Entity Type | Individual
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Provider Name | LOUIS CASTRO
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Gender | Male
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 625 FAIR OAKS AVE STE 255
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-2695
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Country | US
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Telephone | 626-737-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 401 N ORANGE ST # B220
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City | GLENDALE
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State | CA
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Zip | 91203-5524
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 303943
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License Number State | CA
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