Provider Demographics
NPI:1225139223
Name:LACASTO CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:LACASTO CHIROPRACTIC CENTER
Other - Org Name:DONALD S. LA CASTO D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LA CASTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:805-464-4015
Mailing Address - Street 1:PO BOX 3084
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93447-3084
Mailing Address - Country:US
Mailing Address - Phone:805-464-4015
Mailing Address - Fax:805-434-5632
Practice Address - Street 1:292 POSADA LN
Practice Address - Street 2:SUITE A
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4054
Practice Address - Country:US
Practice Address - Phone:805-464-4015
Practice Address - Fax:805-434-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU16906Medicare UPIN