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NPI Code Detail

MEDICARE: JORGE RAMON ROMO P.A.-C

MEDICARE: JORGE RAMON ROMO P.A.-C
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
1363A00000XPhysician AssistantPA16178CA

General Provider Information

NPI Number : 1891852216
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE RAMON ROMO P.A.-C
Provider Business Mailing Address
First Line : 540 SAGEBRUSH ST
Second Line :
City : IMPERIAL
State : CA
Zip : 92251-8961
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 450 E BIRCH ST
Second Line :
City : CALEXICO
State : CA
Zip : 92231-2375
Country : US
Telephone Number : 760-768-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 05/24/2022

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