| Dr Michael Richard Kostura Ii, OD | |
|
21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679-3488 | |
| (949) 459-5687 | |
| (949) 459-5690 |
| Full Name | Dr Michael Richard Kostura Ii |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700913829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 12316T (California) | Primary |
| Provider Name | Kostura Optometric Corp |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1578181491 PECOS PAC ID: 5597175950 Enrollment ID: O20201113001512 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Richard Kostura Ii, OD 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679-3488 Ph: (949) 459-5687 | Dr Michael Richard Kostura Ii, OD 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679-3488 Ph: (949) 459-5687 |
Ecs Of Los Angeles I Optometry Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679 Phone: 618-462-9818 | |
Ecs Of Los Angeles I Optometry Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679 Phone: 618-462-9818 | |
Dr. Sonia Kim Kostura, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 21612 Plano Trabuco Rd Ste C, Trabuco Canyon, CA 92679 Phone: 949-459-5687 Fax: 949-459-5690 |