Provider Demographics
NPI:1851762140
Name:DOBRE, EMIL
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:DOBRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7224 CANDLELIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-3711
Mailing Address - Country:US
Mailing Address - Phone:916-725-5680
Mailing Address - Fax:916-721-1157
Practice Address - Street 1:7224 CANDLELIGHT WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-3711
Practice Address - Country:US
Practice Address - Phone:916-725-5680
Practice Address - Fax:916-721-1157
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347000931310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility