| Loida P Constantino MD Inc | |
|
1777 N Bellflower Blvd Ste 104 Long Beach CA 90815-4013 | |
| (562) 961-8820 | |
| (562) 961-8828 |
| Full Name | Loida P Constantino MD Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1777 N Bellflower Blvd, Long Beach, California |
| Authorized Official Name and Position | Loida P Constantino (OWNER) |
| Authorized Official Contact | 5629618820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loida P Constantino MD Inc 1777 N Bellflower Blvd Ste 104 Long Beach CA 90815-4013 Ph: (562) 961-8820 | Loida P Constantino MD Inc 1777 N Bellflower Blvd Ste 104 Long Beach CA 90815-4013 Ph: (562) 961-8820 |
| NPI Number | 1306983960 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 01/23/2009 |
| Medicare PECOS PAC ID | 0345213294 |
|---|---|
| Medicare Enrollment ID | O20040818000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306983960 | NPI | - | NPPES |
| 05D1028070 | Other | CA | CLIA # |
| 1487767604 | Other | CA | NPI (TYPE-1) |
| 00A398400 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A39840 (California) | Primary |
| Provider Name | Loida P Constantino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487767604 PECOS PAC ID: 7416920368 Enrollment ID: I20040819000974 |
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