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Individual

PETER N COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
973 MICA DRIVE, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191
Mailing address
973 MICA DR, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
7813
NV
208100000X
Physical Medicine & Rehabilitation Physician
G70318
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G703180
MEDI-CAL
CA
05
2013381
NV
01
250010880
MEDICARE RAILROAD
CA
01
NV9682
BCBS
NV
Enumeration date
11/03/2005
Last updated
07/20/2021
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