Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | RS2008-0416 | NM |
Y | 2084N0400X | Neurologist | 2013006235 | MO |
N | 2084N0400X | Neurologist | BP10043934 | TX |
NPI | 1740436971 |
---|---|
Provider Name | Mr. Jorge F Kawano-Castillo |
First Address | Kansas City, MO 64108-2602 |
Second Address | Kansas City, MO 64108-2640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 17/08/2016 |