| Provider / Organization | NPI | Date Certified |
|---|---|---|
| PHOEBEDEL CASTRO REYES | 1700485265 | 2022-08-09 |
Phoebedel Castro Reyes is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1700485265. Registration indicates Phoebedel Castro Reyes is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Phoebedel Castro Reyes MSN, FNP-BC |
| Practice Office Address | 300 UCLA MEDICAL PLZ STE B200 LOS ANGELES, CA US |
| Practice Office Telephone | 3107941195 |
| Mailing Address | 5767 W CENTURY BLVD STE 400 LOS ANGELES, CA 900455631 US |
| Business Telephone | 3103018707 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 400 W 30th St | Los Angeles, CA 900073320 | 2132843200 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | NP95015223
CA |