Individual
DANIEL T. ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
635 C ST, APT. 502, SAN DIEGO, CA 92101-5381
(619) 235-8950
(619) 235-8959
Mailing address
635 C ST, APT. 502, SAN DIEGO, CA 92101-5381
(619) 235-8950
(619) 235-8959
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DXX00002F
—
CA
01
—
ZZZ02268Z
BLUE SHIELD
CA
Enumeration date
10/24/2006
Last updated
12/06/2007
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