Individual
CHRISTINE SUZANNE KOSELAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1936 CAMDEN AVE STE 9, SAN JOSE, CA 95124-2845
(650) 346-4111
Mailing address
14567 BIG BASIN WAY STE D2, SARATOGA, CA 95070-6039
(650) 346-4111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30000094L
CA
Other
Enumeration date
08/15/2017
Last updated
06/14/2021
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