Provider Demographics
NPI:1831737550
Name:SANDRA CASTRO PROFESSIONAL CHIROPRACTIC CORP
Entity type:Organization
Organization Name:SANDRA CASTRO PROFESSIONAL CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-889-3801
Mailing Address - Street 1:575 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3505
Mailing Address - Country:US
Mailing Address - Phone:760-753-1547
Mailing Address - Fax:760-753-1131
Practice Address - Street 1:575 2ND ST
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3505
Practice Address - Country:US
Practice Address - Phone:760-753-1547
Practice Address - Fax:760-753-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty