Provider Demographics
NPI:1083786065
Name:ROMINES AND ROMINES DPM
Entity Type:Organization
Organization Name:ROMINES AND ROMINES DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:ROMINES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:916-743-4593
Mailing Address - Street 1:425 W BONITA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2543
Mailing Address - Country:US
Mailing Address - Phone:909-599-0981
Mailing Address - Fax:909-614-8185
Practice Address - Street 1:11925 RUBILITE WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8071
Practice Address - Country:US
Practice Address - Phone:916-743-4593
Practice Address - Fax:209-474-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24640ZMedicare PIN
CACS9721Medicare PIN