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Organization
PROVIDER SERVICE NETWORK, INC
Active
Organization
PROVIDER SERVICE NETWORK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HECTOR RAPHAEL CASTILLO MD (CEO)
(323) 264-5000
Entity
Organization
Contact information
Practice address
212 BAILEY ST APT 204, LOS ANGELES, CA 90033-2460
(323) 264-5000
(323) 264-5003
Mailing address
212 BAILEY ST APT 204, LOS ANGELES, CA 90033-2460
(323) 264-5000
(323) 264-5003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/25/2019
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