Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | G60275 | CA |
Y | 207Q00000X | Family Doctor | G60275 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | G60275 | CA |
NPI | 1619089943 |
---|---|
Provider Name | Edgar Hugo Castellanos |
First Address | Salinas, CA 93906-3460 |
Second Address | Salinas, CA 93906-3460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G602750 | (05) | CA |
F08866 | (02) | CA |