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John Christian Canet Costumbrado

Emergency Medicine

Allopathic & Osteopathic Physicians

4445 Magnolia Ave, Riverside, CA 92501-4135

PECOS Enrollment

This provider is enrolled in PECOS as JOHN CHRISTIAN COSTUMBRADO.

Based on the most recent information from CMS, provider John Christian Canet Costumbrado is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1033640073
Provider Type
Individual
Full Name
Costumbrado, John Christian Canet
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
3/22/2017
Last Updated
12/3/2021

Contact Information

Practice Location

4445 Magnolia Ave, Riverside, CA 92501-4135

(951) 788-3000

Unlisted Fax

Mailing Location

4445 Magnolia Ave, Riverside, CA 92501-4135

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License A158577 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

John Christian Canet Costumbrado

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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