Provider Demographics
NPI:1568572352
Name:CONSTABILEO, JAMES JOSEPH (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:CONSTABILEO
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:6615 E PACIFIC COAST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4224
Mailing Address - Country:US
Mailing Address - Phone:562-430-1666
Mailing Address - Fax:562-430-1668
Practice Address - Street 1:6615 E PACIFIC COAST HWY STE 200
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4224
Practice Address - Country:US
Practice Address - Phone:562-430-1666
Practice Address - Fax:562-430-1668
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA14807363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical