Individual
ELENA GALLARDO COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-3300
Mailing address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-3300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15543
CA
Other
Enumeration date
11/06/2006
Last updated
01/11/2022
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