Doctor Name: | REYNALDO BORJA CASTILLO |
NPI Number: | 1376665729 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | A39948 |
Business Practice Address: | 2675 E Slauson Ave Huntington Park, CA - 902552926 |
Business Phone Number: | 3235896681 |
Business Fax Number: | 3235894903 |
Mailing Address: | 2675 E Slauson Ave, HUNTINGTON PARK |
State: | CA |
Postal Code: | 902552926 |
Phone Number: | 3235896681 |
Fax Number: | 3235894903 |
NPI Enumeration Date: | 04/05/2007 |
NPI Last Update Date: | 12/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A39948 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |