MEDICARE: MICHAEL PAUL CASTRO RNFA

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	163WR0006X	Registered Nurse First Assistant	545956	CA

General Provider Information

NPI Number	:	1316145261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PAUL CASTRO RNFA

Provider Business Mailing Address
First Line	:	166 N MAGNOLIA AVE
Second Line	:
City	:	MONROVIA
State	:	CA
Zip	:	91016-2133
Country	:	US
Telephone Number	:	626-675-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	10921 CHERRY ST STE 100
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2473
Country	:	US
Telephone Number	:	562-795-5600
Fax Number	:	562-795-5602

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

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

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