Provider Demographics
NPI:1316099716
Name:ULDINE CASTEL, MD, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ULDINE CASTEL, MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ULDINE
Authorized Official - Middle Name:LAMIJANG
Authorized Official - Last Name:CASTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-642-8109
Mailing Address - Street 1:3438 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3026
Mailing Address - Country:US
Mailing Address - Phone:805-642-8109
Mailing Address - Fax:805-642-8100
Practice Address - Street 1:3438 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3026
Practice Address - Country:US
Practice Address - Phone:805-642-8109
Practice Address - Fax:805-642-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A829040Medicaid
CAW20307Medicare PIN
CAWA82904CMedicare PIN
CA00A829040Medicaid