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General NPI Number Information
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NPI Number | 1306983960
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Entity Type | Organization
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Legal Business Name | LOIDA P CONSTANTINO MD INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 1777 N BELLFLOWER BLVD STE 104
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City | LONG BEACH
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State | CA
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Zip | 90815-4013
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Country | US
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Telephone | 562-961-8820
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Fax | 562-961-8828
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Provider Business Mailing Address
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Address Line | 1777 N BELLFLOWER BLVD STE 104
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City | LONG BEACH
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State | CA
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Zip | 90815-4013
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Country | US
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Telephone | 562-961-8820
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Fax | 562-961-8828
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Authorized Official
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Title or Position | OWNER
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Name | LOIDA P CONSTANTINO
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Credential | MD
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Telephone | 562-961-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A39840
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License Number State | CA
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