Provider Demographics
NPI:1548426216
Name:STANCULESCU, IOANA A (MD)
Entity Type:Individual
Prefix:DR
First Name:IOANA
Middle Name:A
Last Name:STANCULESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IOANA
Other - Middle Name:A
Other - Last Name:IANUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2420 CAMINO RAMON
Mailing Address - Street 2:STE 270
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4385
Mailing Address - Country:US
Mailing Address - Phone:925-543-0140
Mailing Address - Fax:925-543-0145
Practice Address - Street 1:2025 MORSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2115
Practice Address - Country:US
Practice Address - Phone:916-973-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119669207L00000X
ORMD28502207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8534364Medicaid
OR279307Medicaid
ORP00677901OtherRR MEDICARE
OR142476Medicare PIN