Provider Demographics
NPI:1144334608
Name:ROMERO, TOMAS EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:TOMAS
Middle Name:EDUARDO
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6600
Mailing Address - Country:US
Mailing Address - Phone:619-216-3113
Mailing Address - Fax:619-216-3204
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 211
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-216-3113
Practice Address - Fax:619-216-3204
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA308870207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87475Medicare UPIN