Individual
DR. JUAN MANUEL CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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