Provider Demographics
NPI:1942359062
Name:CASTRO, SANDRA (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 2ND ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3567
Mailing Address - Country:US
Mailing Address - Phone:760-753-1547
Mailing Address - Fax:760-753-1131
Practice Address - Street 1:550 2ND ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3567
Practice Address - Country:US
Practice Address - Phone:760-753-1547
Practice Address - Fax:760-753-1131
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27729111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation