Individual
DR. WILLIAM M COSTIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 S RAYMOND AVE, PASADENA, CA 91105-3229
(626) 795-8051
(626) 795-0356
Mailing address
PO BOX 90730, PASADENA, CA 91109-0730
(626) 795-8051
(626) 795-0356
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A60548
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200042156
RAIL ROAD MEDICARE
CA
01
—
A60548
MEDICARE INDIVIDUAL ID
CA
Enumeration date
09/27/2005
Last updated
01/26/2009
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