MEDICARE: DALE HENRY COSTANTINO PHARM.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	44592	CA

General Provider Information

NPI Number	:	1598355539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALE HENRY COSTANTINO PHARM.D

Provider Business Mailing Address
First Line	:	1682 E DORCHESTER LN
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-3598
Country	:	US
Telephone Number	:	559-916-1789
Fax Number	:

Provider Business Practice Location Address
First Line	:	5085 E MCKINLEY AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-1964
Country	:	US
Telephone Number	:	559-353-7440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2021
Last Update Date	:	02/17/2026

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