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General NPI Number Information
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NPI Number | 1831708452
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Entity Type | Individual
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Provider Name | EMMA BRAND CONSTANTINOU PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 15107 VANOWEN ST
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City | VAN NUYS
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State | CA
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Zip | 91405-4597
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Country | US
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Telephone | 818-902-5180
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Fax |
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Provider Business Mailing Address
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Address Line | 763 S LOS ROBLES AVE
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City | PASADENA
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State | CA
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Zip | 91106-3740
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Country | US
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Telephone | 865-771-6931
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 58100
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License Number State | CA
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