Individual
JEFFREY WILLIAM CASTRILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 782-6600
Mailing address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A19504
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790291086
KAISER
CA
05
—
1790291086
—
CA
Enumeration date
12/21/2017
Last updated
08/11/2022
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