Provider Demographics
NPI:1356322705
Name:PLOCH, FLORIAN H (MD)
Entity Type:Individual
Prefix:
First Name:FLORIAN
Middle Name:H
Last Name:PLOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NUT TREE RD
Mailing Address - Street 2:#190
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4100
Mailing Address - Country:US
Mailing Address - Phone:707-624-8100
Mailing Address - Fax:707-624-8101
Practice Address - Street 1:1020 NUT TREE RD
Practice Address - Street 2:#190
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4100
Practice Address - Country:US
Practice Address - Phone:707-624-8100
Practice Address - Fax:707-624-8101
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC-351222085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C351220Medicaid
A35846Medicare UPIN
CA00C351220Medicare PIN