Provider Demographics
NPI:1124246350
Name:CONSTANTINO, JONNEL RAMOS (MD)
Entity type:Individual
Prefix:DR
First Name:JONNEL
Middle Name:RAMOS
Last Name:CONSTANTINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 E HEIM AVE
Mailing Address - Street 2:UNIT 18
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3001
Mailing Address - Country:US
Mailing Address - Phone:909-427-5310
Mailing Address - Fax:909-427-4107
Practice Address - Street 1:1800 E HEIM AVE
Practice Address - Street 2:UNIT 18
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-3001
Practice Address - Country:US
Practice Address - Phone:909-427-5310
Practice Address - Fax:909-427-4107
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89569208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A895690Medicare PIN