Daciana I. Iancu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A70894 Issued in CA

Practice address

632 Petaluma Ave
Sebastopol, CA 95472-4217

Phone

(707) 295-3755

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1265582084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724217",
            "telephone_number": "707-295-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724217",
            "telephone_number": "707-295-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANCU",
        "first_name": "DACIANA",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A70894",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A708940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uni Hong, L.AC.
• Sheila J Horowitz, MFT
• Theresa M Hozian, PSYD.
• Janet Elaine Hughes, DC
• Bailey Brian Hyatt, OTD
• Miguel Ibarra
• Tamara Ice
• In-Home Hearing Aid Services
• Integrative Medical Clinic of Santa Rosa, a Professional Corporation
• Kendell Desmond Jack, D.C

• Internal Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.