Individual
MR. JONATHAN EDWARD CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3945 WHITTIER BLVD., LOS ANGELES, CA 90023-1104
(323) 223-6146
(323) 223-6399
Mailing address
3345 MICHELSON DR STE 100, IRVINE, CA 92612-0693
(888) 227-3312
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20136
CA
Other
Enumeration date
08/26/2009
Last updated
09/13/2021
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