MEDICARE: CLINICA MSR. OSCAR A. ROMERO

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
1	261QD0000X	Dental Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1467311753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA MSR. OSCAR A. ROMERO

Provider Business Mailing Address
First Line	:	123 S ALVARADO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2201
Country	:	US
Telephone Number	:	213-989-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 S ALVARADO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2201
Country	:	US
Telephone Number	:	213-989-7700
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE MANAGER
Name	:	SHADMAN SAQIB CHOWDHURY
Credential	:
Telephone Number	:	213-436-5251

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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