Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME96973 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A109681 | CA |
NPI | 1164521035 |
---|---|
Provider Name | Peter A. Castillo |
First Address | Los Gatos, CA 95032-2425 |
Second Address | Los Gatos, CA 95032-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 15/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CP113X | PTAN (01) | CA |