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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801868658 NPPES
Pennsylvania MEDICAID 101479082
Pennsylvania MEDICAID 016288000

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