MEDICARE: ABUNDIO CASTILLO FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95010344	CA

General Provider Information

NPI Number	:	1053888743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABUNDIO CASTILLO FNP

Provider Business Mailing Address
First Line	:	100 E NORTH ST
Second Line	:
City	:	TAFT
State	:	CA
Zip	:	93268-3606
Country	:	US
Telephone Number	:	661-765-1935
Fax Number	:	661-765-7234

Provider Business Practice Location Address
First Line	:	4821 PANAMA LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313-3480
Country	:	US
Telephone Number	:	661-556-4777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	01/05/2023

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