Individual
ALOIZIO VERONICO COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1435 4TH ST, SAN RAFAEL, CA 94901-2847
(415) 724-7861
(925) 481-2943
Mailing address
2412 MARK TWAIN DR, ANTIOCH, CA 94531-8358
(415) 724-7861
(925) 481-2943
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B9768225
CA
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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