Provider Demographics
NPI:1346473170
Name:CASTILLO, ROMELIA N
Entity Type:Individual
Prefix:MRS
First Name:ROMELIA
Middle Name:N
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12589 AVE 416
Mailing Address - Street 2:P.O. BOX 183
Mailing Address - City:OROSI
Mailing Address - State:CA
Mailing Address - Zip Code:93647
Mailing Address - Country:US
Mailing Address - Phone:559-273-3161
Mailing Address - Fax:
Practice Address - Street 1:12589 AVENUE 416
Practice Address - Street 2:12589 AVENUE 416
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647
Practice Address - Country:US
Practice Address - Phone:559-273-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies