Doctor Name: | MS. TANJAY MARIE CASTRO |
NPI Number: | 1497070726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 28582 |
Business Practice Address: | 24203 Alliene Ave Lomita, CA - 907171049 |
Business Phone Number: | 3237179196 |
Business Fax Number: | |
Mailing Address: | 24203 Alliene Ave, LOMITA |
State: | CA |
Postal Code: | 907171049 |
Phone Number: | 3237179196 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2010 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 28582 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |