Provider Demographics
NPI:1023178936
Name:CASTANEDA, AUGUSTO JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:JULIAN
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E ARRELLAGA ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103
Mailing Address - Country:US
Mailing Address - Phone:805-963-4959
Mailing Address - Fax:805-963-0332
Practice Address - Street 1:601 E ARRELLAGA ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103
Practice Address - Country:US
Practice Address - Phone:805-963-4959
Practice Address - Fax:805-963-0332
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42748208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA427480OtherMEDICAL