Provider Demographics
NPI:1164466686
Name:CASTRO, RICARDO F (DC)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:F
Last Name:CASTRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16702 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5824
Mailing Address - Country:US
Mailing Address - Phone:714-367-5360
Mailing Address - Fax:714-635-5428
Practice Address - Street 1:5584 N PARAMOUNT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-5149
Practice Address - Country:US
Practice Address - Phone:562-920-8394
Practice Address - Fax:562-867-6083
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 25047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC25047AMedicare PIN
CACI722RMedicare PIN
CACI722SMedicare PIN
CACI722XMedicare PIN
CACI722WMedicare PIN
CAU68104Medicare UPIN
CACI722VMedicare PIN