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Search › California › Custodial Care Facility

Mickey Iliescu

NPI 1386176808 · on the registry since 2017 · sole proprietor

Practice

Address
7125 Main Ave
Orangevale, CA 95662
Phone
(916) 987-7285
Fax
(916) 987-7165
Organisation at this address
7125 Main, Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
Custodial Care Facility
311Z00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2017-04-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California