Candice Nicole Castro, PA-C
Individual provider Active NPI Surgical Physician Assistant · Laguna Woods, CA
NPI 1457645574 · NPPES record last updated Oct 3, 2023
Key facts
- NPI
- 1457645574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA21621 (CA)
- Practice address
- 24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116 - Phone
- (949) 767-0800
- NPI assigned
- Jun 6, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bci Orthopaedics
Practice addresses (Care Compare)
23521 Paseo de Valencia
Suite 309
Laguna Hills, CA 92653-3144
Phone (949) 229-3500
Hospital & facility affiliations
- Providence Mission Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111025000161 | CA | Practitioner - Physician Assistant | 9032382726 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21621 | CA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA21621 | CA | Yes |
Addresses
Primary practice location
24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Mailing address
16 Via Destino
San Clemente, CA 92673-7013
Phone (949) 370-4335
Other providers in Laguna Woods, CA
- Erik Brauer
- Stefanie M Brown
- Bruce M. Glover, D.D.S. Inc.
- Alexis-Neneh Lindo Camba
- Ruth A Carter
- Chavez Management, Inc
- Julie Miae Choi
- Peter Pe Chu
- Christine Huyen Chung
- Emily Marie Clarke
All providers in Laguna Woods, CA · Surgical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.