Provider Demographics
NPI:1891450532
Name:DAVID, HOEL RUPERT CASTILLO (NP)
Entity type:Individual
Prefix:
First Name:HOEL RUPERT
Middle Name:CASTILLO
Last Name:DAVID
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 BALBOA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1592
Mailing Address - Country:US
Mailing Address - Phone:619-645-0162
Mailing Address - Fax:619-645-0193
Practice Address - Street 1:8808 BALBOA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1592
Practice Address - Country:US
Practice Address - Phone:196-645-0155
Practice Address - Fax:619-645-0193
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95151110163W00000X
CA95018976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse