Healthcare Provider Details

I. General information

NPI: 1790447613
Provider Name (Legal Business Name): ROMEO CHIEM SAECHAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39210 STATE ST STE 220
FREMONT CA
94538-1456
US

IV. Provider business mailing address

4055 COLEMAN CIR
RICHMOND CA
94806-1860
US

V. Phone/Fax

Practice location:
  • Phone: 510-894-4135
  • Fax:
Mailing address:
  • Phone: 510-367-2583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number46-1305562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: