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General NPI Number Information
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NPI Number | 1982284519
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Entity Type | Individual
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Provider Name | CARMEL RUSU
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Gender | Male
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 17635 ALMOND RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-1205
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Country | US
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Telephone | 510-886-0341
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Fax | 410-200-9191
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Provider Business Mailing Address
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Address Line | 17635 ALMOND RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-1205
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Country | US
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Telephone | 510-886-0341
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Fax | 510-200-9191
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 6030659740
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License Number State | CA
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