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General NPI Number Information
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NPI Number | 1659481125
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Entity Type | Individual
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Provider Name | AUDREY M KONOW M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 5150 E LA PALMA AVE STE 106
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City | ANAHEIM
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State | CA
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Zip | 92807-2085
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Country | US
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Telephone | 714-975-1507
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Fax | 714-463-4393
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Provider Business Mailing Address
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Address Line | 601 E YORBA LINDA BLVD STE 1
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-961-8500
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G32179
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License Number State | CA
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