=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114032208
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JESUSA N ROMERO MD A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2006
-----------------------------------------------------
Last Update Date | 05/30/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10230 ARTESIA BLVD STE 209
-----------------------------------------------------
City | BELLFLOWER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90706-6763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-804-5295
-----------------------------------------------------
Fax | 562-504-5296
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9321 FLORENCE AVE
-----------------------------------------------------
City | DOWNEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90240-3508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-804-5295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MD
-----------------------------------------------------
Name | JESUSA NAVARRO ROMERO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 562-804-5295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | A34299
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------