Individual
MR. ALFONSO OVIDIO CASTA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MH
Contact information
Practice address
6331 SANTA FE AVENUE, HUNTINGTON PARK, CA 90255-3805
(323) 391-5935
Mailing address
6331 SANTA FE AVE, HUNTINGTON PARK, CA 90255-3805
(323) 391-5935
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
D9600956
CA
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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