Individual
MICHAEL JOHN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 N STAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
PO BOX 576768, MODESTO, CA 95357-6768
(209) 577-1200
(209) 577-6517
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G71611
CA
Other
Enumeration date
06/15/2007
Last updated
05/12/2026
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