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General NPI Number Information
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NPI Number | 1669586293
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Entity Type | Individual
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Provider Name | CARL A CONSTANTINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 825 N 10TH ST
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City | SANTA PAULA
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State | CA
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Zip | 93060-1309
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Country | US
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Telephone | 805-647-0880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660640
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City | ARCADIA
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State | CA
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Zip | 91066-0640
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Country | US
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Telephone | 626-447-0297
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Fax | 626-447-6057
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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 | G68370
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License Number State | CA
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