Individual
DR. CHRISTOPHER P. COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
821 TEXAS AVE, LOS BANOS, CA 93635
(209) 826-1045
(209) 826-0952
Mailing address
1910 CUSTOMER CARE WAY, ATWATER, CA 95301-5167
(209) 384-6488
(855) 202-9336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20028
NE
207Q00000X
Family Medicine Physician
Primary
G82066
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025207400
—
NE
05
—
4705330312
—
NE
Enumeration date
06/14/2005
Last updated
08/17/2018
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