Provider Demographics
NPI:1568486710
Name:CASTREJON, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:CASTREJON
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 1:2023 W VISTA WAY STE K
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6030
Mailing Address - Country:US
Mailing Address - Phone:760-806-1406
Mailing Address - Fax:760-806-1408
Practice Address - Street 1:2120 THIBODO RD # 120
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7901
Practice Address - Country:US
Practice Address - Phone:760-806-5800
Practice Address - Fax:760-631-3419
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A556070Medicaid
CAWA55607MMedicare ID - Type Unspecified
CAG58053Medicare UPIN