MEDICARE: DR. EDGAR CASTRO AGUILAR O.D.

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	174400000X	Specialist	OPT 12273T	CA

General Provider Information

NPI Number	:	1447246863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDGAR CASTRO AGUILAR O.D.

Provider Business Mailing Address
First Line	:	506 W ATEN RD
Second Line	:
City	:	IMPERIAL
State	:	CA
Zip	:	92251-9718
Country	:	US
Telephone Number	:	760-352-3505
Fax Number	:	760-545-0186

Provider Business Practice Location Address
First Line	:	506 W ATEN RD
Second Line	:
City	:	IMPERIAL
State	:	CA
Zip	:	92251-9718
Country	:	US
Telephone Number	:	760-352-3505
Fax Number	:	760-545-0186

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	05/12/2020

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