| Doctor Name: | DR. CARY COSTA |
| NPI Number: | 1952690901 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.T. |
| License Number: | |
| Business Practice Address: | 22821 Lake Forest Dr Suite 115 Lake Forest, CA - 926301606 |
| Business Phone Number: | 9497165050 |
| Business Fax Number: | 9494822122 |
| Mailing Address: | 22821 Lake Forest Dr, Suite 115 LAKE FOREST |
| State: | CA |
| Postal Code: | 926301606 |
| Phone Number: | 9497165050 |
| Fax Number: | 9494822122 |
| NPI Enumeration Date: | 03/30/2011 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |