Provider Demographics
NPI:1184601445
Name:GEORGE F CASTILLO MD INC
Entity type:Organization
Organization Name:GEORGE F CASTILLO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:FILEMEN
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-843-1497
Mailing Address - Street 1:2701 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4402
Mailing Address - Country:US
Mailing Address - Phone:818-843-1497
Mailing Address - Fax:818-843-5783
Practice Address - Street 1:2701 W ALAMEDA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4402
Practice Address - Country:US
Practice Address - Phone:818-843-1497
Practice Address - Fax:818-843-5783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71583208600000X, 2086S0102X, 2086S0105X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
Not Answered2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Not Answered2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A715830Medicaid
CAW16621Medicare ID - Type Unspecified
CA00A715830Medicaid