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General NPI Number Information
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NPI Number | 1639235831
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Entity Type | Individual
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Provider Name | ROMEO BLAS MARIANO JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 262 EL DORADO ST SUITE 100
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City | MONTEREY
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State | CA
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Zip | 93940-2915
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Country | US
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Telephone | 831-375-6655
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Fax |
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Provider Business Mailing Address
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Address Line | 225 CROSSROADS BLVD PMB 416
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City | CARMEL
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State | CA
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Zip | 93923-8674
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Country | US
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Telephone | 831-375-6655
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G73692
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License Number State | CA
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