MEDICARE: DANIEL CARDENAL CASTRO M.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	207Q00000X	Family Medicine Physician	A146588	CA

General Provider Information

NPI Number	:	1619310075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL CARDENAL CASTRO M.D

Provider Business Mailing Address
First Line	:	3974 SORRENTO VALLEY BLVD UNIT 910954
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92191-7040
Country	:	US
Telephone Number	:	619-864-4287
Fax Number	:

Provider Business Practice Location Address
First Line	:	5651 COPLEY DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-7903
Country	:	US
Telephone Number	:	858-262-6240
Fax Number	:

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

Provider Enumeration Date	:	04/16/2013
Last Update Date	:	06/17/2025

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