Provider Demographics
NPI:1518071604
Name:CASTRO, CARLOS ARMANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ARMANDO
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E 8TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2873
Mailing Address - Country:US
Mailing Address - Phone:619-267-9047
Mailing Address - Fax:619-267-7977
Practice Address - Street 1:2340 E 8TH ST STE A
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2873
Practice Address - Country:US
Practice Address - Phone:619-267-9047
Practice Address - Fax:619-267-7977
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A429111Medicaid
CA00A429111Medicaid
CAA42911Medicare ID - Type Unspecified