Active NPI
Constantine Svimonoff Jr., MD
- Emergency Medicine Physician
- Lakewood, CA
National Provider Identifier
1649209404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A40059
- Practice address
- 3700 South St
Lakewood, CA 90712-1419 - Phone
- (562) 602-6800
- NPI assigned
- Jul 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A40059 | CA | Primary |
Addresses
Primary practice location
3700 South St
Lakewood, CA 90712-1419
Mailing address
5236 E Broadway
Long Beach, CA 90803-1805
Phone (562) 900-1881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A40059 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649209404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5236 E BROADWAY",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908031805",
"telephone_number": "562-900-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 SOUTH ST",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907121419",
"telephone_number": "562-602-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SVIMONOFF",
"first_name": "CONSTANTINE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A40059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.