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Individual
MARK CASTILLO SAMSON
Active
Individual
MARK CASTILLO SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
34786
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34786
STATE LICENSE
CA
Enumeration date
01/20/2021
Last updated
01/20/2021
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