Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G31881 | CA |
NPI | 1023031184 |
---|---|
Provider Name | Thomas J. Romano |
First Address | Los Angeles, CA 90051-6041 |
Second Address | Los Angeles, CA 90033-2464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 11/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G318810 | (05) | CA |
A44900 | (02) | CA |