Healthcare Provider Details

I. General information

NPI: 1326450636
Provider Name (Legal Business Name): RAYMOND ROMERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

1440 E CULLUMBER ST
GILBERT AZ
85234-0403
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-1218
  • Fax: 602-344-1488
Mailing address:
  • Phone: 510-921-9162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number54448
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number54448
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: