MEDICARE: NATALIEANN COSTANZO N.P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	606860	CA
2	364S00000X	Clinical Nurse Specialist	2320	CA

General Provider Information

NPI Number	:	1518038876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIEANN COSTANZO N.P

Provider Business Mailing Address
First Line	:	1403 LOMITA BLVD
Second Line	:	SUITE 100
City	:	HARBOR CITY
State	:	CA
Zip	:	90710-2076
Country	:	US
Telephone Number	:	310-784-5800
Fax Number	:	310-530-9811

Provider Business Practice Location Address
First Line	:	1403 LOMITA BLVD
Second Line	:	SUITE 100
City	:	HARBOR CITY
State	:	CA
Zip	:	90710-2076
Country	:	US
Telephone Number	:	310-784-5800
Fax Number	:	310-530-9811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	09/11/2025

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