Provider Demographics
NPI:1306698147
Name:DECASTRO, STEVEN Y (CNIM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:Y
Last Name:DECASTRO
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N PARKWOOD AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3528
Mailing Address - Country:US
Mailing Address - Phone:213-378-2373
Mailing Address - Fax:
Practice Address - Street 1:31 N PARKWOOD AVE APT 3
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3528
Practice Address - Country:US
Practice Address - Phone:213-378-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic