Individual
DR. JOHN ALBERT COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 E INDIAN SCHOOL RD, 116A, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6010
Mailing address
650 E INDIAN SCHOOL RD, 116A, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6010
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25266
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25266
LICENSE, MEDICAL
AZ
Enumeration date
09/13/2006
Last updated
07/08/2007
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