Organization
CASTO CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLE CASTO D.C. (OWNER / PROVIDER)
(530) 543-1201
Entity
Organization
Contact information
Practice address
1156 EMERALD BAY RD, BLDG. C, SOUTH LAKE TAHOE, CA 96150-6157
(530) 543-1201
(530) 543-1322
Mailing address
15520 ROCKFIELD BLVD STE A200, IRVINE, CA 92618-6705
(949) 598-9999
(949) 598-9990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC28482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427145911
INDIVIDUAL NPI
CA
01
—
DA009Z
INDIVIDUAL PTAN
CA
01
—
DC28482
CHIROPRACTIC LICENSE
CA
01
—
ZZZ53912Y
BLUE SHIELD
CA
Enumeration date
03/12/2009
Last updated
06/17/2020
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