Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 50896 | CA |
Y | 213EG0000X | General Practice | 50896 | CA |
NPI | 1003916818 |
---|---|
Provider Name | Dr. Guillermo Salvador Castillo |
First Address | Hemet, CA 92543-4530 |
Second Address | Hemet, CA 92543-4530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 20/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1658697 | (02) | PA |
G 94099-01 | (05) | CA |