Individual
AUDREY M KONOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5150 E LA PALMA AVE STE 106, ANAHEIM, CA 92807-2085
(714) 975-1507
(714) 463-4393
Mailing address
601 E YORBA LINDA BLVD, STE 1, PLACENTIA, CA 92870-3006
(714) 961-8500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G32179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G321790
—
CA
Enumeration date
08/30/2006
Last updated
02/21/2020
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