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General NPI Number Information
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NPI Number | 1801292909
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Entity Type | Individual
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Provider Name | TARA MARIE CASTLEMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 4170 EL CAMINO REAL
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City | PALO ALTO
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State | CA
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Zip | 94306-4008
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Country | US
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Telephone | 650-858-2007
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Fax |
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Provider Business Mailing Address
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Address Line | 19 PACIFIC BAY CIR APT 106
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City | SAN BRUNO
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State | CA
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Zip | 94066-6144
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Country | US
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Telephone | 716-923-3818
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 72010
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 059488
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License Number State | NY
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