Individual
GABRIEL A CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
Mailing address
4460 CARMEN ST, CHINO, CA 91710-3970
(626) 290-3167
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT30357
CA
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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