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Individual
DR. STEVEN JON COSTALES
Active
Individual
DR. STEVEN JON COSTALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., M.S., A.T.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC27735
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202613906
GROUP NPI
CA
01
—
W18889
MEDICARE GROUP PTAN
CA
01
—
WDC27735A
MEDICARE PTAN
CA
Enumeration date
08/04/2008
Last updated
08/04/2008
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