Provider Demographics
NPI:1801872346
Name:CASTRO, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 CRAVEN ST BLDG 3300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92136-5599
Mailing Address - Country:US
Mailing Address - Phone:619-556-8800
Mailing Address - Fax:
Practice Address - Street 1:327 CORAL SEA DRIVE
Practice Address - Street 2:SUITE 165
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-5025
Practice Address - Country:US
Practice Address - Phone:361-776-4575
Practice Address - Fax:361-776-1103
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058627207Q00000X
CAC146103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine