Provider Demographics
NPI:1598916587
Name:KONTNY, EWA (MD)
Entity Type:Individual
Prefix:DR
First Name:EWA
Middle Name:
Last Name:KONTNY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9591 WARBURTON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-3629
Mailing Address - Country:US
Mailing Address - Phone:714-614-2917
Mailing Address - Fax:888-990-0671
Practice Address - Street 1:16200 SAND CANYON AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3714
Practice Address - Country:US
Practice Address - Phone:888-655-8463
Practice Address - Fax:888-990-0671
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116169207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT39020000XOtherTAXONOMY
CAP01002245OtherMEDICARE RAILROAD
CT39020000XOtherTAXONOMY