Individual
BRANDON COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
HIGHWAY 1, SAN LUIS OBISPO, CA 93409-0001
(805) 547-7559
Mailing address
HIGHWAY 1, SAN LUIS OBISPO, CA 93409-0001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
51572
CA
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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