Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 36.003949 | OH |
N | 222Z00000X | Podiatrist | 36.003949 | OH |
N | 213E00000X | Podiatrist | E5680 | CA |
N | 222Z00000X | Podiatrist | E5680 | CA |
N | 213ES0103X | Foot & Ankle Surgery | 36.003949 | OH |
Y | 213ES0103X | Foot & Ankle Surgery | E5680 | CA |
NPI | 1013363084 |
---|---|
Provider Name | Dr. Michael Lecastre |
First Address | Richmond Hieghts, OH 44124 |
Second Address | Thousand Oaks, CA 91361-5231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2016 |
Last Update Date | 24/07/2020 |