Doctor Name: | DR. PABLO R CASTRO |
NPI Number: | 1538422316 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 12389 |
Business Practice Address: | 1901 W Kettleman Ln Suite 200 Lodi, CA - 952424337 |
Business Phone Number: | 2093348540 |
Business Fax Number: | 2093682885 |
Mailing Address: | Po Box 241011, LODI |
State: | CA |
Postal Code: | 952419511 |
Phone Number: | 2093397435 |
Fax Number: | 2093333054 |
NPI Enumeration Date: | 06/18/2012 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |