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General NPI Number Information
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NPI Number | 1871871616
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Entity Type | Individual
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Provider Name | MAURICIO ROMERO OLVERA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 105 W 8TH AVE STE 150E
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City | SPOKANE
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State | WA
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Zip | 99204-2302
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Country | US
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Telephone | 509-252-1704
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31001-4114
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City | PASADENA
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State | CA
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Zip | 91110-4114
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Country | US
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Telephone | 866-747-2455
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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 | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | MD61687228
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | 4301097904
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | S4378
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License Number State | TX
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