Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 12420 | NV |
N | 2080P0202X | Pediatric Cardiologist | 20947 | WV |
NPI | 1093895286 |
---|---|
Provider Name | Dr. William J Castillo |
First Address | Las Vegas, NV 89109-2218 |
Second Address | Las Vegas, NV 89109-2218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 07/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093895286 | (05) | NV |
2003496000 | (05) | WV |
H69780 | (02) | |
NV8114 | BLUE CROSS BLUE SHIELD (01) | |
VWCLCQ | MEDICARE GROUP (01) | NV |