Provider Demographics
NPI:1114083151
Name:CASTRO, MARTHA (DC)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27574 COMMERCE CENTER DR
Mailing Address - Street 2:STE 131
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2535
Mailing Address - Country:US
Mailing Address - Phone:951-587-6932
Mailing Address - Fax:
Practice Address - Street 1:27574 COMMERCE CENTER DR
Practice Address - Street 2:STE 131
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2535
Practice Address - Country:US
Practice Address - Phone:951-587-6932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22979111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition