Provider Demographics
NPI:1841723657
Name:MUNIZ CASTRO, JOSE CARLOS (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:CARLOS
Last Name:MUNIZ 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 1:71943 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4848
Mailing Address - Country:US
Mailing Address - Phone:760-776-7600
Mailing Address - Fax:
Practice Address - Street 1:71943 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4848
Practice Address - Country:US
Practice Address - Phone:607-767-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA184636208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery