Provider Demographics
NPI:1104026566
Name:CASTILLO, KARLO (PT)
Entity Type:Individual
Prefix:
First Name:KARLO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1194 S DE ANZA BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3632
Mailing Address - Country:US
Mailing Address - Phone:408-257-2225
Mailing Address - Fax:408-257-2485
Practice Address - Street 1:525 SOUTH DR
Practice Address - Street 2:SUITE 211
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4213
Practice Address - Country:US
Practice Address - Phone:650-934-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 33749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist