Organization Active NPI

Konstantinos Vlachonassios MD Inc

  • Cardiovascular Disease Physician
  • Long Beach, CA
National Provider Identifier
1851429260
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KONSTANTINOS VLACHONASSIOS MD INC
Practice address
3300 E South Street
Suite 301
Long Beach, CA 90805
Phone
(562) 622-9500
Fax
(562) 622-9513
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Konstantinos Vlachonassios, M.D.NPI 1851473003
Title
President
Phone
(562) 622-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

3300 E South Street
Suite 301
Long Beach, CA 90805

Mailing address

19051 Goldenwest St
Suite 106321
Huntington Beach, CA 92648-2155
Phone (562) 622-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050818001056 CA Part B Supplier - Clinic/Group Practice 9537199518 Receives reassigned benefits from 1 practitioner
Practice locations: Downey, CA

National Provider Directory

National Provider Directory

Locations

11101 La Reina Ave
#210
Downey, CA 90241

19051 Goldenwest St
Ste 106321
Huntington Beach, CA 92648

3300 E South St
Ste 301
Lakewood, CA 90805
Phone (562) 622-9500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1851429260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19051 GOLDENWEST ST",
            "address_2": "SUITE 106321",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482155",
            "telephone_number": "562-622-9500",
            "fax_number": "562-622-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH STREET",
            "address_2": "SUITE 301",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "562-622-9500",
            "fax_number": "562-622-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONSTANTINOS VLACHONASSIOS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "VLACHONASSIOS",
        "authorized_official_first_name": "KONSTANTINOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-622-9500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.