Individual
DR. SOFIA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
900 WILSHIRE BLVD, SUIT #318, SANTA MONICA, CA 90401-1872
(347) 451-3626
(424) 272-9772
Mailing address
932 14TH ST, UNIT #3, SANTA MONICA, CA 90403-3186
(956) 357-6774
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
39664
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39664
STATE LICENSE
CA
Enumeration date
12/03/2012
Last updated
06/24/2016
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