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NPI Code Detail

MEDICARE: CARLEEN KAYLE CAPULONG CASTRO MD

MEDICARE:   CARLEEN KAYLE CAPULONG CASTRO  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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1982547758
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLEEN KAYLE CAPULONG CASTRO MD
Provider Business Mailing Address
First Line : 2534 BEVERLY BLVD APT 202
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-1030
Country : US
Telephone Number : 213-570-3124
Fax Number :
Provider Business Practice Location Address
First Line : 2534 BEVERLY BLVD APT 202
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-1030
Country : US
Telephone Number : 213-570-3124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ CARLEEN KAYLE CAPULONG CASTRO MD” Practice Location

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