Provider Demographics
NPI:1881705168
Name:DEL CASTILLO, ALEXANDER NIEVA (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:NIEVA
Last Name:DEL CASTILLO
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:PO BOX 271220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1220
Mailing Address - Country:US
Mailing Address - Phone:801-268-7766
Mailing Address - Fax:801-270-3381
Practice Address - Street 1:1160 E 3900 S
Practice Address - Street 2:G200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1202
Practice Address - Country:US
Practice Address - Phone:801-268-7766
Practice Address - Fax:801-270-3381
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3746741205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005745027Medicare ID - Type UnspecifiedONSITE
H03011Medicare UPIN