MEDICARE: MS. ILENE SHARON CASTRO PT

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	2251H1200X	Hand Physical Therapist	14580	CA

General Provider Information

NPI Number	:	1285852814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ILENE SHARON CASTRO PT

Provider Business Mailing Address
First Line	:	26191 SAN ROQUE DR
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-4935
Country	:	US
Telephone Number	:	949-855-9060
Fax Number	:

Provider Business Practice Location Address
First Line	:	2362 MORSE AVE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-6234
Country	:	US
Telephone Number	:	949-863-1769
Fax Number	:	949-863-1601

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/08/2007

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