Individual
DR. DERRICK DCOSTA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
888 S HILL RD, VENTURA, CA 93003-8400
(805) 477-6464
(805) 477-6498
Mailing address
2590 E MAIN ST, VENTURA, CA 93003-2619
(805) 477-6464
(805) 477-6498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A40728
CA
Other
Enumeration date
06/18/2006
Last updated
07/08/2007
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