Provider Demographics
NPI:1619069325
Name:CASTLE, STEVEN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:CASTLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8307 HOLY CROSS PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2632
Mailing Address - Country:US
Mailing Address - Phone:310-268-4671
Mailing Address - Fax:310-268-4842
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:VA GREATER LOS ANGELES 11G
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-4671
Practice Address - Fax:310-268-4842
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG058595207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD000Medicare UPIN