Individual
STEPHANIE CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 PRECISION PARK LN, SAN YSIDRO, CA 92173-1345
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN YSIDRO, CA 92173-1345
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
A159673
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2017
Last updated
08/03/2021
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