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NPI Code Detail

MEDICARE: MICHELLE CONSTANTINO

MEDICARE: MICHELLE CONSTANTINO
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
1163W00000XRegistered Nurse831810CA

General Provider Information

NPI Number : 1194007849
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CONSTANTINO
Provider Business Mailing Address
First Line : 5300 ANGELES VISTA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1648
Country : US
Telephone Number : 323-295-4555
Fax Number :
Provider Business Practice Location Address
First Line : 5300 ANGELES VISTA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-1648
Country : US
Telephone Number : 323-295-4555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2011
Last Update Date : 05/15/2014

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Directions to “ MICHELLE CONSTANTINO ” Practice Location

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