Healthcare Provider Details
I. General information
NPI: 1760583041
Provider Name (Legal Business Name): DANTON KONO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6555 COYLE AVE
CARMICHAEL CA
95608-0302
US
IV. Provider business mailing address
3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US
V. Phone/Fax
- Phone: 916-536-2500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A78727 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: