Provider Demographics
NPI:1629246624
Name:CASTLE FAMILY HEALTH CENTERS INC
Entity Type:Organization
Organization Name:CASTLE FAMILY HEALTH CENTERS INC
Other - Org Name:CASTLE FAMILY HEALTH CENTER URGENT CARE & RADIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LUJANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-381-2000
Mailing Address - Street 1:3605 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5173
Mailing Address - Country:US
Mailing Address - Phone:209-381-2000
Mailing Address - Fax:209-726-0278
Practice Address - Street 1:3605 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5173
Practice Address - Country:US
Practice Address - Phone:209-381-2000
Practice Address - Fax:209-723-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care