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NPI Code Detail

MEDICARE: DR. BLAIR LYNN ROMER M.D.

MEDICARE: DR. BLAIR LYNN ROMER M.D.
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
12084P0800XPsychiatry PhysicianG079022CA

General Provider Information

NPI Number : 1639172190
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLAIR LYNN ROMER M.D.
Provider Business Mailing Address
First Line : 11670 ATWOOD RD
Second Line :
City : AUBURN
State : CA
Zip : 95603-9522
Country : US
Telephone Number : 530-887-2800
Fax Number :
Provider Business Practice Location Address
First Line : 11670 ATWOOD RD
Second Line :
City : AUBURN
State : CA
Zip : 95603-9522
Country : US
Telephone Number : 530-887-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 09/11/2014

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