Individual
DR. RUPERTO CASTANEDA VALLARTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 NW LARCH AVE, REDMOND, OR 97756-1357
(541) 548-2164
(541) 548-0534
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 548-2164
(541) 548-0534
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD166206
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003642900
—
FL
Enumeration date
05/26/2011
Last updated
09/25/2014
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