Provider Demographics
NPI:1841557733
Name:CASTRO, DAVID ANDRES (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDRES
Last Name:CASTRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:ANDRES
Other - Last Name:CASTRO GOTTSCHALK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:819 D AVE UNIT 209
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3404
Mailing Address - Country:US
Mailing Address - Phone:314-874-6596
Mailing Address - Fax:
Practice Address - Street 1:1016 OUTER RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1351
Practice Address - Country:US
Practice Address - Phone:619-429-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013012111N00000X
OH4264111N00000X
CADC36311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor