Provider Demographics
NPI:1225383045
Name:COSKO, DIANE TATJANA (DVM)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:TATJANA
Last Name:COSKO
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93225-0759
Mailing Address - Country:US
Mailing Address - Phone:661-248-7387
Mailing Address - Fax:661-248-7023
Practice Address - Street 1:837 LEBEC RD.
Practice Address - Street 2:
Practice Address - City:LEBEC
Practice Address - State:CA
Practice Address - Zip Code:93243
Practice Address - Country:US
Practice Address - Phone:661-248-7387
Practice Address - Fax:661-248-7023
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVD9570174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian