Individual
JEFFREY DE CASTRO MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3699 WILSHIRE BLVD, 3RD FLOOR KAISER DEPT OF CONTINUING CARE, LOS ANGELES, CA 90010-2718
(323) 783-1490
(323) 783-4120
Mailing address
3699 WILSHIRE BLVD, 3RD FLOOR KAISER DEPT OF CONTINUING CARE, LOS ANGELES, CA 90010-2718
(323) 783-1490
(323) 783-4120
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A81061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A810610
—
CA
Enumeration date
07/19/2006
Last updated
12/03/2021
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