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General NPI Number Information
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NPI Number | 1689176901
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Entity Type | Individual
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Provider Name | RANDALL ROMBERG
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Gender | Male
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 1807 XIMENO AVE
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City | LONG BEACH
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State | CA
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Zip | 90815-2850
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Country | US
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Telephone | 562-494-7374
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Fax | 562-597-8736
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Provider Business Mailing Address
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Address Line | 750 N COMMONS DR STE 200
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City | AURORA
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State | IL
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Zip | 60504-7940
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Country | US
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Telephone | 630-303-5380
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Fax | 630-303-5385
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA8145
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License Number State | CA
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