Healthcare Provider Details

I. General information

NPI: 1518146828
Provider Name (Legal Business Name): FLORIN VLASIE M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W H ST SUITE 330
OAKDALE CA
95361-3588
US

IV. Provider business mailing address

1425 W H ST SUITE 330
OAKDALE CA
95361-3588
US

V. Phone/Fax

Practice location:
  • Phone: 209-848-8133
  • Fax: 209-845-2134
Mailing address:
  • Phone: 209-848-8133
  • Fax: 209-845-2134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA101671
License Number StateCA

VIII. Authorized Official

Name: DR. FLORIN VLASIE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 209-848-8133