Provider Demographics
NPI:1063515336
Name:CASTRO, DANIEL F (PA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:F
Last Name:CASTRO
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2121 NORTH AVE
Mailing Address - Street 2:2121 VA MEDICAL CENTER
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6428
Mailing Address - Country:US
Mailing Address - Phone:970-242-0731
Mailing Address - Fax:970-242-0731
Practice Address - Street 1:2121 NORTH AVE
Practice Address - Street 2:2121 VA MEDICAL CENTER
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6428
Practice Address - Country:US
Practice Address - Phone:970-242-0731
Practice Address - Fax:970-242-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1970363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant