| Castellanos Family Practice | |
|
234 E Badillo St Covina CA 91723-2115 | |
| (626) 915-9992 | |
| (626) 915-6108 |
| Full Name | Castellanos Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 234 E Badillo St, Covina, California |
| Authorized Official Name and Position | Jose Gabriel Castellanos (PRESIDENT) |
| Authorized Official Contact | 6268593297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Castellanos Family Practice 234 E Badillo St Covina CA 91723-2115 Ph: (626) 915-9992 | Castellanos Family Practice 234 E Badillo St Covina CA 91723-2115 Ph: (626) 915-9992 |
| NPI Number | 1891875621 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 09/20/2024 |
| Medicare PECOS PAC ID | 4981660347 |
|---|---|
| Medicare Enrollment ID | O20041207000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891875621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A62398 (California) | Primary |
| Provider Name | Jose G Castellanos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669486783 PECOS PAC ID: 7416913876 Enrollment ID: I20041207001175 |
| Provider Name | Michelle Lee Noto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427396878 PECOS PAC ID: 3476771445 Enrollment ID: I20140904001822 |
| Provider Name | Gisselle Lara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417656992 PECOS PAC ID: 2365800257 Enrollment ID: I20230626001332 |
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