Michelle Deanne Kostner, P.A.
Physician Assistant, Medical in San Diego, CA. Individual provider (NPI-1).
NPI number1891197943
StatusActive
Last updated in NPPESMar 22, 2017
Details
- NPI
- 1891197943
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Michelle Deanne Kostner
- Credential
- P.A.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2014
- Last updated
- Mar 22, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 51929 | CA | Yes |
Practice location
10605 Scripps Poway Pkwy#c
San Diego, CA 92131-3925
Phone 858-622-0554
Mailing address
12521 Mustang DrPoway, CA 92064
Phone 714-458-7543
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