Organization
CHRISTOPHER COSTANZO M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER COSTANZO MD (PRESIDENT)
(805) 373-9919
Entity
Organization
Contact information
Practice address
2190 LYNN RD, SUITE 380, THOUSAND OAKS, CA 91360-1980
(805) 373-9919
(805) 379-3495
Mailing address
2190 LYNN RD, SUITE 380, THOUSAND OAKS, CA 91360-1980
(805) 373-9919
(805) 379-3495
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
G46454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G46454
MEDICAL LICENSE
CA
Enumeration date
03/31/2008
Last updated
07/02/2015
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