Healthcare Provider Details

I. General information

NPI: 1275857971
Provider Name (Legal Business Name): VALENTIN ISACESCU MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 S EL CAMINO REAL STE 100
OCEANSIDE CA
92054
US

IV. Provider business mailing address

2122 S EL CAMINO REAL STE 100
OCEANSIDE CA
92054-6209
US

V. Phone/Fax

Practice location:
  • Phone: 760-726-6464
  • Fax: 760-726-6483
Mailing address:
  • Phone: 760-726-6464
  • Fax: 760-726-6483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA68103
License Number StateCA

VIII. Authorized Official

Name: VALENTIN ISACESCU
Title or Position: OWNER
Credential: M.D.
Phone: 760-726-6464