| Elizabeth Kostrey, Md, Inc | |
|
2258 Foothill Blvd Suite300 La Canada CA 91011-1457 | |
| (818) 957-2248 | |
| (818) 249-1425 |
| Full Name | Elizabeth Kostrey, Md, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2258 Foothill Blvd, La Canada, California |
| Authorized Official Name and Position | Elizabeth Kostrey (PRESIDENT) |
| Authorized Official Contact | 8189572248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Kostrey, Md, Inc 2258 Foothill Blvd Suite300 La Canada CA 91011-1457 Ph: (818) 957-2248 | Elizabeth Kostrey, Md, Inc 2258 Foothill Blvd Suite300 La Canada CA 91011-1457 Ph: (818) 957-2248 |
| NPI Number | 1982633616 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 02/25/2011 |
| Medicare PECOS PAC ID | 9638173529 |
|---|---|
| Medicare Enrollment ID | O20060907000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982633616 | NPI | - | NPPES |
| 1851347769 | Other | CA | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | A76521 (California) | Primary |
| Provider Name | Elizabeth J Kostrey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851347769 PECOS PAC ID: 7214994763 Enrollment ID: I20041215001077 |
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