Provider Demographics
NPI:1295586055
Name:PATRICK CASTILLO MSOT
Entity type:Organization
Organization Name:PATRICK CASTILLO MSOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MSOT
Authorized Official - Phone:661-674-6007
Mailing Address - Street 1:217 HAWK LN
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3618
Mailing Address - Country:US
Mailing Address - Phone:661-674-6007
Mailing Address - Fax:
Practice Address - Street 1:217 HAWK LN
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3618
Practice Address - Country:US
Practice Address - Phone:661-674-6007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty