Provider Demographics
NPI:1235629361
Name:CASTANARES, ANTHONY JOHN E (OD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOHN E
Last Name:CASTANARES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7763 SQUIRREL CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3718
Mailing Address - Country:US
Mailing Address - Phone:925-548-6143
Mailing Address - Fax:
Practice Address - Street 1:7763 SQUIRREL CREEK CIR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568
Practice Address - Country:US
Practice Address - Phone:925-548-6143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33918TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist