Provider Demographics
NPI:1679763981
Name:CASTILLO, NOEL M (RPH)
Entity type:Individual
Prefix:MR
First Name:NOEL
Middle Name:M
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 FALVO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3240
Mailing Address - Country:US
Mailing Address - Phone:702-561-2205
Mailing Address - Fax:
Practice Address - Street 1:7321 FALVO AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-3240
Practice Address - Country:US
Practice Address - Phone:702-561-2205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13038183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist