Provider Demographics
NPI:1922431733
Name:CASTILLO, RAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 E 15TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2333
Mailing Address - Country:US
Mailing Address - Phone:909-694-4200
Mailing Address - Fax:909-652-4700
Practice Address - Street 1:659 E 15TH ST STE D
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2333
Practice Address - Country:US
Practice Address - Phone:909-694-4200
Practice Address - Fax:419-730-7802
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor