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General NPI Number Information
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NPI Number | 1922457191
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Entity Type | Individual
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Provider Name | MICHELLE CASTILLONES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 1650 LOS GAMOS DR STE 270
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1852
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Country | US
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Telephone | 415-482-6819
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Fax |
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Provider Business Mailing Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 73653
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License Number State | CA
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