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NPI Code Detail

MEDICARE: DR.ROMANENKO , INC, A PROFESSIONAL CORPORATION

MEDICARE: DR.ROMANENKO , INC, A PROFESSIONAL CORPORATION
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
1207V00000XObstetrics & Gynecology PhysicianA94512CA

General Provider Information

NPI Number : 1164714275
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR.ROMANENKO , INC, A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 874 BIRCHWOOD DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-2502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10024 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-3112
Country : US
Telephone Number : 323-240-1938
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DMITRIY ROMANENKO
Credential : M.D.
Telephone Number : 323-240-1938
Provider Enumeration Date : 05/08/2011
Last Update Date : 05/08/2011

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Directions to “DR.ROMANENKO , INC, A PROFESSIONAL CORPORATION ” Practice Location

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