Healthcare Provider Details

I. General information

NPI: 1366062119
Provider Name (Legal Business Name): ELIZA NAVA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 SEPULVEDA BLVD
CULVER CITY CA
90230-4820
US

IV. Provider business mailing address

2000 E 4TH ST STE 201
SANTA ANA CA
92705-3907
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-6612
  • Fax:
Mailing address:
  • Phone: 714-547-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: