Individual
MARILYN CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4930 WYCONDA LN, SAN DIEGO, CA 92113-3565
(619) 586-0772
Mailing address
4010 PETERLYNN CT, SAN DIEGO, CA 92154-3750
(626) 926-0511
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B6716299
DRIVER LICENSE
—
Enumeration date
12/03/2021
Last updated
12/03/2021
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