Provider Demographics
NPI:1629202148
Name:DRS2C, INC
Entity Type:Organization
Organization Name:DRS2C, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-208-9055
Mailing Address - Street 1:12463 RANCHO BERNARDO RD # 116
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2143
Mailing Address - Country:US
Mailing Address - Phone:858-673-7738
Mailing Address - Fax:858-673-7738
Practice Address - Street 1:15725 POMERADO RD STE 201
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2058
Practice Address - Country:US
Practice Address - Phone:858-673-7722
Practice Address - Fax:858-673-7738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67938174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF81516Medicare UPIN