Provider Demographics
NPI:1073820528
Name:CASTILLO, ARTURO (PAC)
Entity type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5622 N GALANTO AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-4800
Mailing Address - Country:US
Mailing Address - Phone:626-216-6042
Mailing Address - Fax:
Practice Address - Street 1:2033 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4073
Practice Address - Country:US
Practice Address - Phone:213-413-5093
Practice Address - Fax:213-413-2465
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant