Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A153308 | CA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | A153308 | CA |
NPI | 1285933424 |
---|---|
Provider Name | Anna Marie Acosta |
First Address | Long Beach, CA 90804-2157 |
Second Address | Long Beach, CA 90804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2011 |
Last Update Date | 01/08/2018 |