Individual
WALTER FRANCIS D'COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2281 CLEVELAND AVE, SANTA ROSA, CA 95403-2905
(707) 544-3337
(707) 544-0608
Mailing address
2281 CLEVELAND AVE, SANTA ROSA, CA 95403-2905
(707) 544-3337
(707) 544-0608
Taxonomy
Speciality
Code
Description
License number
State
213ER0200X
Radiology Podiatrist
RHC116746
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E2603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E26030
—
CA
01
—
170924000
US DEPARTMENT OF LABOR
—
01
—
756480842
RAILROAD MEDICARE
—
Enumeration date
11/28/2006
Last updated
08/01/2012
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