CASTILLO PRIMARY CARE NPI 1912293374

NPI Information

CASTILLO PRIMARY CARE is a primary care clinic center in Pueblo, CO. CASTILLO PRIMARY CARE NPI is 1912293374. The provider is registered as an organization entity type.

The provider's business location address is:

1401 ANITA ST
PUEBLO, CO
ZIP 81001-122
Phone: (719) 225-6510
Fax: (719) 542-3514

The provider's authorized official is Pauline S. Castillo .
The authorized official title is Owner/provider and has the following contact phone number (719) 225-6510.

The CLIA number assigned to this NPI record is 06D2030568 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2011 and was last updated on 6/23/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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