Individual
CONSTANTINO DONACIANO ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2677 1/2 ZOE AVE., HUNTINGTON PARK, CA 90255
(323) 312-0640
(323) 312-0642
Mailing address
2677 1/2 ZOE AVE., HUNTINGTON PARK, CA 90255
(323) 312-0640
(323) 312-0642
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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