Individual
DR. CONSTANTINOS CHRYSOSTOMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17360 BROOKHURST STREET, ATTN: NETWORK MANAGEMENT, FOUNTAIN VALLEY, CA 92708-3720
(714) 377-2900
Mailing address
17360 BROOKHURST STREET, ATTN: NETWORK MANAGEMENT, FOUNTAIN VALLEY, CA 92708-3720
(714) 377-2900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD426904
PA
2080P0202X
Pediatric Cardiology Physician
Primary
C129462
CA
2080P0202X
Pediatric Cardiology Physician
ME126009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016288000
—
FL
05
—
101479082
—
PA
Enumeration date
02/06/2006
Last updated
06/23/2022
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