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General NPI Number Information
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NPI Number | 1558230219
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Entity Type | Individual
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Provider Name | JEREMY RODIL ROMERO MUNGUIA
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Gender | Male
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 25176 RYE CANYON RD
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City | VALENCIA
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State | CA
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Zip | 91355-3488
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Country | US
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Telephone | 661-288-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 15610 LUCILLE CT
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-4438
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Country | US
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Telephone | 818-703-2333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 55424
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License Number State | CA
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