Organization
COSTA ACUPUNCTURE PROF CORP
Active
Other names
Costa Acupuncture
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E COSTA L.AC. (PRESIDENT)
(310) 838-2817
Entity
Organization
Contact information
Practice address
10200 VENICE BLVD, STE 109B, CULVER CITY, CA 90232-3346
(310) 838-2817
Mailing address
10200 VENICE BLVD, STE 109B, CULVER CITY, CA 90232-3346
(310) 838-2817
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC11005
CA
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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