Individual provider · NPI-1

Isaac Acosta

Student in an Organized Health Care Education/Training Program · Tempe, AZ

NPI number1285505164
StatusActive
Last updated in NPPESSep 15, 2025

Details

NPI
1285505164
Entity type
Individual (NPI-1)
Name
Isaac Acosta
Sex
Male
Sole proprietor
No
Enumeration date
Sep 15, 2025
Certification date
Sep 15, 2025
Last updated
Sep 15, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training ProgramI026989AZYes

Practice location

1750 E Broadway Rd
Tempe, AZ 85282-1612

Phone 480-557-0970

Mailing address

4411 N 99th Ave Unit 3029
Phoenix, AZ 85037-1380

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