Individual provider · NPI-1

Crystal Faith Castillo, PAC

Physician Assistant · Robbinsdale, MN

NPI number1104872597
StatusActive
Last updated in NPPESAug 21, 2007

Details

NPI
1104872597
Entity type
Individual (NPI-1)
Name
Crystal Faith Castillo
Credential
PAC
Sex
Female
Sole proprietor
No
Enumeration date
May 26, 2006
Last updated
Aug 21, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant10099MNYes

Practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Phone 763-520-5330 · Fax 763-520-2834

Mailing address

2800 Campus Dr #10
Plymouth, MN 55441-2645

Phone 763-398-2203 · Fax 763-398-2233

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