Provider Demographics
NPI:1538522768
Name:ROME, CAMBIA SUSSETTE GREEN (MD)
Entity type:Individual
Prefix:DR
First Name:CAMBIA
Middle Name:SUSSETTE GREEN
Last Name:ROME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAMBIA
Other - Middle Name:SUSSETTE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 889442
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-9442
Mailing Address - Country:US
Mailing Address - Phone:559-603-7372
Mailing Address - Fax:
Practice Address - Street 1:2335 E KASHIAN LN STE 220
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2211
Practice Address - Country:US
Practice Address - Phone:559-453-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA156869208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program