Basic Information
| Provider Information | |||||||||
| NPI: | 1548426216 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STANCULESCU | ||||||||
| FirstName: | IOANA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | IANUS | ||||||||
| OtherFirstName: | IOANA | ||||||||
| OtherMiddleName: | A | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2420 CAMINO RAMON | ||||||||
| Address2: | STE 270 | ||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945834385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9255430140 | ||||||||
| FaxNumber: | 9255430145 | ||||||||
| Practice Location | |||||||||
| Address1: | 2025 MORSE AVE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958252115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169735000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 01/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A119669 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MD28502 | OR | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 8534364 | 05 | WA | MEDICAID | 279307 | 05 | OR | MEDICAID | P00677901 | 01 | OR | RR MEDICARE | OTHER |