Provider Demographics
NPI:1841589819
Name:BLOSIU, CODRIN JULIAN (DC)
Entity Type:Individual
Prefix:
First Name:CODRIN
Middle Name:JULIAN
Last Name:BLOSIU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 VIA DE LA VALLE UNIT D
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2483
Mailing Address - Country:US
Mailing Address - Phone:858-405-0454
Mailing Address - Fax:619-814-5544
Practice Address - Street 1:3636 FIFTH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4230
Practice Address - Country:US
Practice Address - Phone:619-814-5500
Practice Address - Fax:619-814-5544
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor