Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICKEY ILIESCU
Active Sole ProprietorMR. MICKEY ILIESCU is a Custodial Care Facility healthcare provider located in ORANGEVALE, California. NPI 1386176808 is currently active in the NPPES registry. Verify at CMS.
Custodial Care Facility · ORANGEVALE, CA
Registration Details
- NPI Number
- 1386176808
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 3, 2017 (9.3777900007071 yrs)
- Last Updated
- Apr 3, 2017
- License
-
347003704 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7125 MAIN AVEORANGEVALE, CA, 956622813Browse CA providers · Browse ZIP 95662
- Phone
- 9169877285
- Fax
- 9169877165
- Primary Specialty
-
Custodial Care Facility
311Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.