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Individual

DR. JUAN MANUEL CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 282-6559
(541) 282-6710
Mailing address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 282-6559
(541) 282-6710

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD24186
OR
2086S0129X
Vascular Surgery Physician
Primary
MD24186
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
114894
MEDICARE
OR
05
181998
OR
01
4898015
BLUE CROSS
OR
Enumeration date
10/17/2006
Last updated
05/15/2015
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