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Brandon Michael Costello, DO
Military Health Care Provider in San Diego, California
NPI 1740556174

Brandon Michael Costello is a Military Health Care Provider based in Hamburg, CA. Brandon Michael Costello practices in San Diego, CA and has the professional credentials of DO. The NPI Number for Brandon Michael Costello is 1740556174 and holds a License No. (California).

The current practice location address for Brandon Michael Costello is 34800 Bob Wilson Dr, San Diego, CA and can be reached out via phone at 619-532-6474.

Location: 34800 Bob Wilson Dr, San Diego, CA, 14075-6823
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740556174
Provider Name
Brandon Michael Costello
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
34800 Bob Wilson Dr, San Diego, CA, 14075-6823
Phone Number
619-532-6474
Fax Number
Provider Enumeration Date
03/29/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
34800 Bob Wilson Dr
City
San Diego
State
California
Zip
92134-1098
Phone Number
619-532-6474
Fax Number
person
Provider Business Mailing Address Details
Address
34800 Bob Wilson Dr
City
San Diego
State
California
Zip
92134-1098
Phone Number
619-532-6474
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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