Provider Demographics
NPI:1346392370
Name:CASTANEDA, JOSE AALBERTO (DC)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:AALBERTO
Last Name:CASTANEDA
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 1:718 N. EUCLID AVE.
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3427
Mailing Address - Country:US
Mailing Address - Phone:909-391-2789
Mailing Address - Fax:909-391-3446
Practice Address - Street 1:718 N. EUCLID AVE.
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3427
Practice Address - Country:US
Practice Address - Phone:909-391-2789
Practice Address - Fax:909-391-3446
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11872111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist