Healthcare Provider Details

I. General information

NPI: 1285550509
Provider Name (Legal Business Name): MADISON BROOKE ROMERO AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 W ADAMS BLVD
LOS ANGELES CA
90018-2039
US

IV. Provider business mailing address

2160 W ADAMS BLVD
LOS ANGELES CA
90018-2039
US

V. Phone/Fax

Practice location:
  • Phone: 213-748-5481
  • Fax: 213-749-1651
Mailing address:
  • Phone: 213-748-5481
  • Fax: 213-749-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU4176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: