Provider Demographics
NPI:1437416179
Name:ISTRATE, LAURENTIU (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENTIU
Middle Name:
Last Name:ISTRATE
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 1:4908 FALCON DR
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-9226
Mailing Address - Country:US
Mailing Address - Phone:541-331-1320
Mailing Address - Fax:
Practice Address - Street 1:1815 W REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8054
Practice Address - Country:US
Practice Address - Phone:909-289-4075
Practice Address - Fax:909-363-8233
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61374801207Q00000X
ORMD171773207QA0505X, 208M00000X
CAA150281207R00000X, 208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD171773OtherOREGON MEDICAL BOARD LICENSE: MD171773