Provider Demographics
NPI:1356502322
Name:RARELA, DAN JAMES CASTILLO (DPT)
Entity Type:Individual
Prefix:DR
First Name:DAN JAMES
Middle Name:CASTILLO
Last Name:RARELA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84410 ONDA DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-2910
Mailing Address - Country:US
Mailing Address - Phone:760-342-5501
Mailing Address - Fax:
Practice Address - Street 1:49613 HARRISON ST STE A105
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1451
Practice Address - Country:US
Practice Address - Phone:760-391-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-22
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist