Individual
RICHARD D DE CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1850 SULLIVAN AVE, SUITE 330, DALY CITY, CA 94015-2223
(650) 756-5630
(650) 756-0136
Mailing address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(213) 484-7781
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA19596
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA19596
STATE
CA
Enumeration date
04/03/2008
Last updated
09/17/2010
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