Individual
JAMISSON COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 SEPULVEDA BLVD, TORRANCE, CA 90505-2804
(310) 325-5885
(310) 539-6049
Mailing address
2900 SEPULVEDA BLVD, TORRANCE, CA 90505-2804
(310) 325-5885
(310) 539-6049
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043656234
ATHENANET
—
Enumeration date
03/05/2018
Last updated
03/05/2018
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