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General NPI Number Information
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NPI Number | 1548415979
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Entity Type | Individual
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Provider Name | JOHN KARL KONSTANTIN M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 2584 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94602-2928
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Country | US
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Telephone | 510-530-5400
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Fax | 510-530-2921
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Provider Business Mailing Address
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Address Line | 2584 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94602-2928
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Country | US
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Telephone | 510-530-5400
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Fax | 510-530-2921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A102896
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License Number State | CA
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