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General NPI Number Information
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NPI Number | 1982775672
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Entity Type | Organization
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Legal Business Name | CASTILLEJOS EYE INSTITUTE MEDICAL GROUP
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 342 F ST
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City | CHULA VISTA
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State | CA
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Zip | 91910
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Country | US
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Telephone | 619-422-1471
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Fax | 619-422-0450
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Provider Business Mailing Address
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Address Line | 342 F ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-2625
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Country | US
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Telephone | 619-422-1471
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Fax | 619-422-0450
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | MARIA E CASTILLEJOS
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Credential | M.D.
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Telephone | 619-422-1471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A37652
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License Number State | CA
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