MEDICARE: VANESSA CASTINE MD

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	207V00000X	Obstetrics & Gynecology Physician	G37651	CA

General Provider Information

NPI Number	:	1821493289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA CASTINE MD

Provider Business Mailing Address
First Line	:	8391 BEVERLY BLVD
Second Line	:	369
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-2633
Country	:	US
Telephone Number	:	714-337-3979
Fax Number	:

Provider Business Practice Location Address
First Line	:	8391 BEVERLY BLVD
Second Line	:	369
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-2633
Country	:	US
Telephone Number	:	714-337-3979
Fax Number	:

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

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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