Individual
CRYSTAL FAITH CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-5330
(763) 520-2834
Mailing address
2800 CAMPUS DR #10, PLYMOUTH, MN 55441-2645
(763) 398-2203
(763) 398-2233
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10099
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123659
MEDICA
MN
01
—
HP62370
HEALTHPARTNERS
FM
Enumeration date
05/26/2006
Last updated
08/21/2007
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