Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 81314 | AZ |
N | 111NI0900X | Internist | 81314 | AZ |
Y | 207RP1001X | Pulmonary Disease | 42944 | AZ |
NPI | 1033315601 |
---|---|
Provider Name | Cristian N Jivcu |
First Address | Mesa, AZ 85206-1346 |
Second Address | Paradise Valley, AZ 85253-1073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 13/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
945196 | (05) | AZ |
Z171598 | MEDICARE (01) | AZ |