MEDICARE: DR. ELIZABETH P CASTANEDA DMD

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	1223G0001X	General Practice Dentistry	33557	CA

General Provider Information

NPI Number	:	1265558944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH P CASTANEDA DMD

Provider Business Mailing Address
First Line	:	4342 ATLANTIC AVENUE
Second Line	:	SUITE A
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2829
Country	:	US
Telephone Number	:	562-981-1437
Fax Number	:	562-981-1438

Provider Business Practice Location Address
First Line	:	4342 ATLANTIC AVENUE
Second Line	:	SUITE A
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2829
Country	:	US
Telephone Number	:	562-981-1437
Fax Number	:	562-981-1438

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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