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NPI Code Detail

MEDICARE: MR. LUIS CASTRO PA

MEDICARE:  MR. LUIS  CASTRO  PA
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
1207Q00000XFamily Medicine PhysicianPA13399CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891801833
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIS CASTRO PA
Provider Business Mailing Address
First Line : 1930 WILSHIRE BLVD
Second Line : SUITE 1100
City : LOS ANGELES
State : CA
Zip : 90057-3605
Country : US
Telephone Number : 213-483-2620
Fax Number : 213-483-7918
Provider Business Practice Location Address
First Line : 1832 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-3227
Country : US
Telephone Number : 213-413-1255
Fax Number : 213-413-2843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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Directions to “ MR. LUIS CASTRO PA” Practice Location

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