Provider Demographics
NPI:1295969954
Name:CASTELLANOS, JORGE M (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:M
Last Name:CASTELLANOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2001 WESTCLIFF DR STE 301
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5553
Mailing Address - Country:US
Mailing Address - Phone:949-881-7883
Mailing Address - Fax:949-258-5368
Practice Address - Street 1:2001 WESTCLIFF DR STE 301
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5553
Practice Address - Country:US
Practice Address - Phone:949-881-7883
Practice Address - Fax:949-258-5368
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA107434207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology