Healthcare Provider Details

I. General information

NPI: 1437183340
Provider Name (Legal Business Name): RICHARD ALAN VROMAN C.R.N.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 N CHINA LAKE BLVD
RIDGECREST CA
93555-3130
US

IV. Provider business mailing address

525 BROTHERTON RD
ESCONDIDO CA
92025-6453
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-0073
  • Fax: 714-935-0075
Mailing address:
  • Phone: 760-920-2430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number331103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: