MEDICARE: ADAN DE JESUS ROMERO LOPEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A144650	CA

General Provider Information

NPI Number	:	1033520002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAN DE JESUS ROMERO LOPEZ MD

Provider Business Mailing Address
First Line	:	1155 N FULLER AVE APT 102
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5056
Country	:	US
Telephone Number	:	661-447-7632
Fax Number	:	424-429-6755

Provider Business Practice Location Address
First Line	:	12021 WILMINGTON AVE BLDG 11
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-3019
Country	:	US
Telephone Number	:	424-529-6755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	12/18/2025

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