Individual
LISA M CASTELLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6567 E CARONDELET DR, SUITE 225, TUCSON, AZ 85710-6152
(520) 886-3432
(520) 886-0169
Mailing address
3501 E SPEEDWAY BLVD, TUCSON, AZ 85716-3917
(520) 886-3432
(520) 886-0169
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3950
AZ
207UN0901X
Nuclear Cardiology Physician
3950
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222863
—
AZ
01
—
3950
STATE LICENSE
AZ
01
—
P00958347
RR MEDICARE
AZ
Enumeration date
03/20/2007
Last updated
03/07/2023
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