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MARK ACOSTA — OIG Excluded Provider (LA PUENTE, CA, 1128b4)

MARK ACOSTA — OIG Excluded Provider (LA PUENTE, CA, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: MARK ACOSTA; Type: Individual; Provider category: IND- LIC HC SERV PRO.

NameMARK ACOSTA
TypeIndividual
Provider categoryIND- LIC HC SERV PRO
SpecialtyNURSE/NURSES AIDE
CityLA PUENTE
StateCA
ZIP91744
Exclusion authority1128b4
Exclusion reasonLicense revocation, suspension, or surrender
Exclusion date2015-01-20
SourceHHS-OIG LEIE

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