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NPI Code Detail

MEDICARE: ROMEO N. MANALO

MEDICARE: ROMEO N. MANALO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesDME02359FCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417170218
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROMEO N. MANALO
Provider Business Mailing Address
First Line : 570 N TOWNE AVE
Second Line :
City : POMONA
State : CA
Zip : 91767-4826
Country : US
Telephone Number : 626-472-7155
Fax Number : 626-472-0167
Provider Business Practice Location Address
First Line : 570 N TOWNE AVE
Second Line :
City : POMONA
State : CA
Zip : 91767-4826
Country : US
Telephone Number : 626-472-7155
Fax Number : 626-472-0167
Authorized Official
Title or Position : OWNER/CEO
Name : MR. ROMEO N MANALO SR.
Credential : MBA
Telephone Number : 626-472-7155
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/30/2018

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