Healthcare Provider Details

I. General information

NPI: 1740437953
Provider Name (Legal Business Name): YONA NICOLAU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: IOANA ANTONELA MOS M.D.

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

IV. Provider business mailing address

4 IRONWOOD
IRVINE CA
92604-3264
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5174
  • Fax:
Mailing address:
  • Phone: 949-232-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA105019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: