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General NPI Number Information
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NPI Number | 1295122562
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Entity Type | Organization
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Legal Business Name | DRAGOS DIACONESCU MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 21530 PIONEER BLVD
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City | HAWAIIAN GARDENS
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State | CA
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Zip | 90716-2608
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Country | US
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Telephone | 562-860-0401
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | DRAGOS DIACONESCU
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Credential | MD
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Telephone | 617-905-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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