Basic Information
| Provider Information | |||||||||
| NPI: | 1578978813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASTELLANO | ||||||||
| FirstName: | ALEXA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 S VICTORIA AVE, L4615 | ||||||||
| Address2: | VCHCA - PHYSICIAN SERVICES | ||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930090003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056775181 | ||||||||
| FaxNumber: | 8056775304 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 HILLMONT AVE | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930031651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056526556 | ||||||||
| FaxNumber: | 8056523252 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 09/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 125.065078 | IL | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | A162090 | CA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.