Provider Demographics
NPI:1649282559
Name:LA CASTO, DONALD S JR (DC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:S
Last Name:LA CASTO
Suffix:JR
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 1:502 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-3169
Mailing Address - Country:US
Mailing Address - Phone:805-239-1252
Mailing Address - Fax:805-239-2865
Practice Address - Street 1:502 SPRING ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-3169
Practice Address - Country:US
Practice Address - Phone:805-239-1252
Practice Address - Fax:805-239-2865
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16683111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU16906Medicare UPIN
CADC16683Medicare PIN