Individual
CYNTHIA M COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
403 WEST ADAMS BLVD, LOS ANGELES, CA 90007-2629
(213) 742-1433
(213) 742-1496
Mailing address
415 KNIGHT WAY, LA CANADA, CA 91011-2725
(818) 790-1309
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
313570
CA
Other
Enumeration date
08/16/2006
Last updated
10/24/2013
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