Basic Information
Provider Information
NPI: 1346376720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASTLE
FirstName: RACHEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3626 RUFFIN RD
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921231810
CountryCode: US
TelephoneNumber: 8585659666
FaxNumber: 8585659441
Practice Location
Address1: 3626 RUFFIN RD
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921231810
CountryCode: US
TelephoneNumber: 8585659666
FaxNumber: 8585659441
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 12/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA100586CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0A100586001CABS OF CAOTHER
134637672005CA MEDICAID


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