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General NPI Number Information
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NPI Number | 1114019379
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Entity Type | Organization
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Legal Business Name | JOHN D ROMM MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 8920 WILSHIRE BLVD STE #330
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2007
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Country | US
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Telephone | 310-854-5638
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Fax |
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Provider Business Mailing Address
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Address Line | 8920 WILSHIRE BLVD STE #330
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2007
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Country | US
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Telephone | 310-854-5638
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOHN D ROMM
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Credential | M.D.
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Telephone | 310-654-5638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C19015
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License Number State | CA
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