Provider Demographics
NPI:1689837767
Name:ORNELAS, CONSTANCE JAYNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:JAYNE
Last Name:ORNELAS
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:3747 WORSHAM AVE
Mailing Address - Street 2:#201
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1774
Mailing Address - Country:US
Mailing Address - Phone:562-420-9800
Mailing Address - Fax:562-420-9884
Practice Address - Street 1:3747 WORSHAM AVE
Practice Address - Street 2:#201
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1774
Practice Address - Country:US
Practice Address - Phone:562-420-9800
Practice Address - Fax:562-420-9884
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2013-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAEL 1761213ES0103X
CAE4930213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery