Individual
MRS. MICHELLE DEANNE KOSTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
10605 SCRIPPS POWAY PKWY, #C, SAN DIEGO, CA 92131-3925
(858) 622-0554
Mailing address
12521 MUSTANG DR, POWAY, CA 92064
(714) 458-7543
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51929
CA
Other
Enumeration date
09/19/2014
Last updated
03/22/2017
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