Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 22305 | CA |
NPI | 1194002477 |
---|---|
Provider Name | Dr. Joella Margarita Castillo |
First Address | San Francisco, CA 94114-3615 |
Second Address | San Francisco, CA 94131-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2011 |
Last Update Date | 14/11/2011 |