Provider Demographics
NPI:1750562815
Name:CASTANEDA, PETER (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:CASTANEDA
Suffix:
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 1:10625 HALEDON AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2812
Mailing Address - Country:US
Mailing Address - Phone:213-200-8470
Mailing Address - Fax:562-923-5000
Practice Address - Street 1:10625 HALEDON AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-2812
Practice Address - Country:US
Practice Address - Phone:213-200-8470
Practice Address - Fax:562-923-5000
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20544111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health