Chrysostomou, Constantinos
Chrysostomou, Constantinos is an individual health care provider with primary practice located at 17360 Brookhurst Street Attn: Network Management, Fountain Valley CA 92708-3720. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is his primary health care specialty. Chrysostomou, Constantinos can be contacted via phone (714) 377-2900.Contact Information
Primary practice address
17360 Brookhurst Street Attn: Network Management
Fountain Valley CA 92708-3720
Phone: (714) 377-2900
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | MD426904 | Pennsylvania |
Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | ME126009 | Florida |
Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | C129462 | California |
Profile Details
NPI number | 1801868658 |
---|---|
LBN Legal business name | Chrysostomou, Constantinos |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 6th, 2006 |
Last updated | Jun 23rd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1801868658 | NPPES |
Pennsylvania | MEDICAID | 101479082 | |
Pennsylvania | MEDICAID | 016288000 |
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