Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A103959 | CA |
N | 208600000X | Surgeon | A103959 | CA |
Y | 2086S0120X | Pediatric Surgery | A103959 | CA |
NPI | 1184871675 |
---|---|
Provider Name | Dr. Shannon Leigh Castle |
First Address | Los Angeles, CA 90010-2814 |
Second Address | San Diego, CA 92103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 11/06/2018 |