Provider Demographics
NPI:1841747029
Name:CASTRO, JOSE FELIX
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:FELIX
Last Name:CASTRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 W ADAMS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-3515
Mailing Address - Country:US
Mailing Address - Phone:323-731-3534
Mailing Address - Fax:
Practice Address - Street 1:2640 INDUSTRY WAY STE 200
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-4284
Practice Address - Country:US
Practice Address - Phone:310-627-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program