Provider Demographics
NPI:1760583041
Name:KONO, DANTON (MD)
Entity Type:Individual
Prefix:
First Name:DANTON
Middle Name:
Last Name:KONO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78727208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A787270OtherBLUE SHIELD
CA00A787270Medicaid
CA7855513OtherAETNA
CA90134729OtherPACIFICARE
CA000810474742OtherPHCS
CA94808OtherINTERPLAN
CAMCMG256300OtherWESTERN HEALTH ADVANTAGE
CA2109476OtherFIRST HEALTH
CA1648401OtherGREAT WEST
CA2311134OtherUNITED HEALTHCARE
CA2892107OtherCIGNA
CAA78727OtherBLUE CROSS
CA100908OtherHEALTH NET
CA94808OtherINTERPLAN
CA90134729OtherPACIFICARE