Individual
MR. IOAN RADU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1022 E IRMA LN, PHOENIX, AZ 85024-4113
(623) 587-1491
(623) 587-1491
Mailing address
1022 E IRMA LN, PHOENIX, AZ 85024-4113
(623) 587-1491
(623) 587-1491
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALH-5811
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118399
ALTECS PROVIDER ID
AZ
Enumeration date
12/04/2007
Last updated
12/04/2007
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