Healthcare Provider Details

I. General information

NPI: 1639601842
Provider Name (Legal Business Name): COSMIN FLORESCU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 05/07/2024
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-1451
  • Fax:
Mailing address:
  • Phone: 760-773-1451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA169408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: