Provider Demographics
NPI:1073643979
Name:KROM, WILFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:
Last Name:KROM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 S HOPE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2674
Mailing Address - Country:US
Mailing Address - Phone:213-250-9900
Mailing Address - Fax:213-250-9380
Practice Address - Street 1:2300 S HOPE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2674
Practice Address - Country:US
Practice Address - Phone:213-250-9900
Practice Address - Fax:213-250-9380
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA25264207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B50010Medicare UPIN